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General NPI Number Information
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NPI Number | 1932382892
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Entity Type | Organization
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Legal Business Name | BENDELL A&D SERVICES
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 114 BRUCE ST
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3558
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Country | US
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Telephone | 865-774-4432
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Fax |
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Provider Business Mailing Address
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Address Line | 114 BRUCE ST
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3558
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TROLAN BRUCE INGLE
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Credential | M.A.
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Telephone | 865-774-4432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 0000000551
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License Number State | TN
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