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General NPI Number Information
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NPI Number | 1396888574
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Entity Type | Organization
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Legal Business Name | GREENE COUNTY SKILLS, INC.
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 130 BOB SMITH BLVD
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City | GREENEVILLE
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State | TN
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Zip | 37745-4223
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Country | US
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Telephone | 423-798-7100
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Fax | 423-798-7146
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Provider Business Mailing Address
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Address Line | 130 BOB SMITH BLVD
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City | GREENEVILLE
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State | TN
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Zip | 37745-4223
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Country | US
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Telephone | 423-798-7100
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Fax | 423-798-7150
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JIM D. GILLEN
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Credential |
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Telephone | 423-798-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | L 3(20)4M6-056-1334
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License Number State | TN
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