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NPI 1396133096 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Kingsport, TN
Provider details
- NPI number
- 1396133096
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Jeffrey Mckee, Chief Operating Officer(423) 612-8628
Specialties & taxonomies
Residential Treatment Facilities
Agencies
- Community/Behavioral Health Agency251S00000X
Agencies
- In Home Supportive Care Agency253Z00000X
Agencies
Profile Score
Established profile(74/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
305 Spearhead Cir
Kingsport, TN 37664-6200
Phone: (423) 323-5092
Fax: (423) 323-5092
Street-level locationGet directions
Mailing address
305 Spearhead Cir
Kingsport, TN 37664-6200
Registry dates
- Enumerated
- 2015-01-03
- Last updated
- 2015-01-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.