MEDICARE: SPECIAL NEEDS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	PSS0000000127	TN

General Provider Information

NPI Number	:	1588701767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIAL NEEDS, INC.

Provider Business Mailing Address
First Line	:	5331 MOUNT VIEW RD
Second Line	:	PMB172
City	:	ANTIOCH
State	:	TN
Zip	:	37013-2308
Country	:	US
Telephone Number	:	615-941-3039
Fax Number	:	615-941-3039

Provider Business Practice Location Address
First Line	:	353 BATTLE RD
Second Line	:
City	:	CANE RIDGE
State	:	TN
Zip	:	37013-4809
Country	:	US
Telephone Number	:	615-941-3039
Fax Number	:	615-941-3039

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MARGARET SANGUINETTI
Credential	:	PT
Telephone Number	:	615-941-3039

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	11/10/2011

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Directions to “SPECIAL NEEDS, INC. ” Practice Location

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