| Takoma Regional Hospital, Inc | |
|
401 Takoma Ave Greeneville TN 37743-4647 | |
| (423) 639-3151 | |
| (423) 636-2399 |
| Full Name | Takoma Regional Hospital, Inc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 401 Takoma Ave, Greeneville, Tennessee |
| Authorized Official Name and Position | Mary Lynn Krutak (EVP/CFO) |
| Authorized Official Contact | 4233023423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Takoma Regional Hospital, Inc 311 Princeton Rd Suite 1 Johnson City TN 37601-2026 Ph: (423) 639-3151 | Takoma Regional Hospital, Inc 401 Takoma Ave Greeneville TN 37743-4647 Ph: (423) 639-3151 |
| NPI Number | 1265561450 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 04/01/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265561450 | NPI | - | NPPES |
| 4400050 | Medicaid | TN | |
| 100020449 | Other | TN | PREFERRED HEALTH |
| 1000393 | Other | TN | BLUE CROSS |
| A3774301 | Other | TN | JOHN DEERE |
| A3774401 | Other | TN | AMERICHOICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 54 (Tennessee) | Primary |
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