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General NPI Number Information
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NPI Number | 1932484607
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Entity Type | Organization
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Legal Business Name | SOUTHEAST TN HUMAN RESOURCE AGENCY
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 165 EDWARDS STREET SE
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City | CLEVELAND
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State | TN
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Zip | 37311
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Country | US
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Telephone | 423-478-1396
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Fax | 423-478-3956
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Provider Business Mailing Address
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Address Line | 312 RESOURCE AGENCY
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City | DUNLAP
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State | TN
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Zip | 37327-0909
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Country | US
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Telephone | 423-949-2191
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Fax | 423-949-4023
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. NANCY D SUTHERLAND
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Credential |
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Telephone | 423-949-2191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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