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General NPI Number Information
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NPI Number | 1932496502
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Entity Type | Organization
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Legal Business Name | CHURCH STREET UNITED METHODIST CHURCH
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Dates
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Enumeration Date | 07/05/2011
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Last Update Date | 07/05/2011
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Provider Practice Location Address
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Address Line | 900 HENLEY ST
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City | KNOXVILLE
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State | TN
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Zip | 37902-3005
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Country | US
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Telephone | 865-521-0293
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Fax | 865-521-0288
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Provider Business Mailing Address
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Address Line | 900 HENLEY ST
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City | KNOXVILLE
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State | TN
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Zip | 37902-3005
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Country | US
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Telephone | 865-521-0293
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Fax | 865-521-0288
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Authorized Official
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Title or Position | DIRECTOR
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Name | JUDITH CHRISTINE WINTERS
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Credential | MPH
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Telephone | 865-521-0293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 47/24147A
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License Number State | TN
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