Provider Demographics
NPI:1104162817
Name:CEREBRAL PALSY CENTER FOR HANDICAPPED ADULTS, INC.
Entity type:Organization
Organization Name:CEREBRAL PALSY CENTER FOR HANDICAPPED ADULTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SEXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-523-0491
Mailing Address - Street 1:241 E WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-6348
Mailing Address - Country:US
Mailing Address - Phone:865-523-0491
Mailing Address - Fax:865-523-0492
Practice Address - Street 1:241 E WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-6348
Practice Address - Country:US
Practice Address - Phone:865-523-0491
Practice Address - Fax:865-523-0492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000011749251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services