Basic Information
| Provider Information | |||||||||
| NPI: | 1124375944 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TK BEHAVIORAL LLC | ||||||||
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| OtherOrganizationName: | TIMBERLINE KNOLLS RESIDENTIAL TREATMENT CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 830 CRESCENT CENTRE DR | ||||||||
| Address2: | SUITE 610 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370677217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158616000 | ||||||||
| FaxNumber: | 6152619685 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 TIMBERLINE DR | ||||||||
| Address2: | |||||||||
| City: | LEMONT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604393848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8772579612 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2012 | ||||||||
| LastUpdateDate: | 08/10/2012 | ||||||||
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| AuthorizedOfficialLastName: | SCHWIEGER | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
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| AuthorizedOfficialTitleorPosition: | DEPUTY GENERAL COUNSEL | ||||||||
| AuthorizedOfficialTelephone: | 6158617330 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 323P00000X | Y | Residential Treatment Facilities | Psychiatric Residential Treatment Facility |
No ID Information.