| Emory Valley Center | |
|
723 Emory Valley Rd Oak Ridge TN 37830-7017 | |
| (865) 483-4385 | |
| (865) 482-5435 |
| Full Name | Emory Valley Center |
|---|---|
| Speciality | Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Location | 723 Emory Valley Rd, Oak Ridge, Tennessee |
| Authorized Official Name and Position | Heather Cupp (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8658130595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emory Valley Center 723 Emory Valley Rd Oak Ridge TN 37830-7017 Ph: (865) 483-4385 | Emory Valley Center 723 Emory Valley Rd Oak Ridge TN 37830-7017 Ph: (865) 483-4385 |
| NPI Number | 1073657136 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 08/03/2020 |
| Certification Date | 08/03/2020 |
| Medicare PECOS PAC ID | 8022436567 |
|---|---|
| Medicare Enrollment ID | O20200915001573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073657136 | NPI | - | NPPES |
| Provider Name | Heather Jo Cupp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417344763 PECOS PAC ID: 0446678999 Enrollment ID: I20200915001746 |
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