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General NPI Number Information
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NPI Number | 1760844559
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Entity Type | Organization
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Legal Business Name | HELEN R TUCKER ADULT DEVELOPMENT CENTER,INC
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 2660 HIGHWAY 51 N
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City | RIPLEY
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State | TN
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Zip | 38063-8114
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Country | US
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Telephone | 731-635-4290
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Fax | 731-635-8975
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Provider Business Mailing Address
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Address Line | PO BOX 648
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City | RIPLEY
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State | TN
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Zip | 38063-0648
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Country | US
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Telephone | 731-635-4290
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Fax | 731-635-8975
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SUZANNE ELIZABETH WIEBER
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Credential |
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Telephone | 731-635-4290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | L000000014226
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License Number State | TN
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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 | L000000014226
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License Number State | TN
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