TEN BROECK TENNESSEE PHYSICIANS GROUP INC
NPI 1083236012
Clinic/Center - Adult Mental Health in Vandalia, IL

Q: What is Ten Broeck Tennessee Physicians Group Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

Active since May 13, 2020

802 N 8TH ST, VANDALIA, IL 62471(618) 283-1731(618) 283-0590 Get Directions Write a Review

NPPES record last updated: May 13, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Ten Broeck Tennessee Physicians Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TEN BROECK TENNESSEE PHYSICIANS GROUP INC (NPI 1083236012), doing business as Center For Senior Renewal, is a healthcare organization registered as an adult mental health in Vandalia, Illinois and active in the NPI registry since May 2020. The organization lists Glenda F Guy, Director, Compliance, as its authorized official.

NPPES Registry Identity

NPI1083236012

Entity TypeOrganization

Primary Taxonomy261QM0850X

Legal Business NameTEN BROECK TENNESSEE PHYSICIANS GROUP INC

Location Address802 N 8TH STVandalia, IL 62471-1756

Mailing Address1 Medical Center BlvdCookeville, TN 38501-4294 · (931) 783-2511 · Fax (931) 783-2550

Phone(618) 283-1731

Fax(618) 283-0590

Organization SubpartNo

Authorized OfficialGlenda F GuyDirector, Compliance · (931) 783-2511

Enumeration DateMay 13, 2020

NPPES CertifiedMay 13, 2020

✔ NPI 1083236012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities

Taxonomy Code261QM0850X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

802 N 8TH ST, Vandalia, IL 62471

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Other Names 1

Doing Business AsCenter For Senior Renewal

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. AMBER MICHELLE SMITH MS, LCPC

Counselor (Professional)

802 N 8TH ST
VANDALIA, IL 62471

Fayette County (618) 293-1731

MR. ETHAN JONES MA

Counselor (Professional)

802 N 8TH ST
VANDALIA, IL 62471

Fayette County (618) 283-1731

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ten Broeck Tennessee Physicians Group Inc's NPI number?

The NPI number for Ten Broeck Tennessee Physicians Group Inc is 1083236012. It was assigned to this organization in the NPPES registry on May 13, 2020. The provider is doing business as Center for Senior Renewal.

Where is Ten Broeck Tennessee Physicians Group Inc located?

Ten Broeck Tennessee Physicians Group Inc is located at 802 N 8th St, Vandalia, IL 62471. The listed phone number is (618) 283-1731.

What is Ten Broeck Tennessee Physicians Group Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for Ten Broeck Tennessee Physicians Group Inc was last updated on May 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.