Provider Demographics
NPI:1306982665
Name:MCNAIRY COUNTY DEVELOPMENTAL SERVICES
Entity type:Organization
Organization Name:MCNAIRY COUNTY DEVELOPMENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:TEUBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-645-7730
Mailing Address - Street 1:565 INDUSTRIAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:SELMER
Mailing Address - State:TN
Mailing Address - Zip Code:38375-3278
Mailing Address - Country:US
Mailing Address - Phone:731-645-7730
Mailing Address - Fax:731-645-9118
Practice Address - Street 1:565 INDUSTRIAL PARK DR
Practice Address - Street 2:
Practice Address - City:SELMER
Practice Address - State:TN
Practice Address - Zip Code:38375-3278
Practice Address - Country:US
Practice Address - Phone:731-645-7730
Practice Address - Fax:731-645-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL3(2)4M40966344251C00000X
343900000X
TNPSS0000000053251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)