| Church Street Pavilion/victory Center | |
|
616 E Church St Greeneville TN 37745-5084 | |
| (423) 639-3213 | |
| (423) 467-3644 |
| Full Name | Church Street Pavilion/victory Center |
|---|---|
| Speciality | Clinic/center - Rehabilitation |
| Location | 616 E Church St, Greeneville, Tennessee |
| Authorized Official Name and Position | E. Douglas Varney (PRESIDENT & CEO) |
| Authorized Official Contact | 4234673600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Church Street Pavilion/victory Center Po Box 9054 Gray TN 37615-9054 Ph: (423) 467-3600 | Church Street Pavilion/victory Center 616 E Church St Greeneville TN 37745-5084 Ph: (423) 639-3213 |
| NPI Number | 1841518867 |
|---|---|
| Provider Enumeration Date | 05/14/2010 |
| Last Update Date | 05/14/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841518867 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | I000000006376 (Tennessee) | Secondary |
| 261QR0400X | Clinic/center - Rehabilitation | I000000006376 (Tennessee) | Primary |
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