Provider Demographics
NPI:1174750731
Name:SKILLS TRAINING AND REHABILITATION SERVICES
Entity type:Organization
Organization Name:SKILLS TRAINING AND REHABILITATION SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:DW
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS
Authorized Official - Phone:423-447-2590
Mailing Address - Street 1:439 ALLEN P. DEAKINS ROAD
Mailing Address - Street 2:PO 673
Mailing Address - City:PIKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37367
Mailing Address - Country:US
Mailing Address - Phone:423-447-2590
Mailing Address - Fax:423-447-7351
Practice Address - Street 1:439 ALLEN P. DEAKINS ROAD
Practice Address - Street 2:PO 673
Practice Address - City:PIKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37367
Practice Address - Country:US
Practice Address - Phone:423-447-2590
Practice Address - Fax:423-447-7351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000003535251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services