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Organization
COLEMANS HOME INC.
Active
Organization
COLEMANS HOME INC.
Active
Other names
colemans personal support service
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEONARD NA COLEMAN III BCBS (PRESIDENT /DIRECTOR)
(423) 698-9120
Entity
Organization
Contact information
Practice address
2101 S WATKINS ST, CHATTANOOGA, TN 37404-5333
(423) 698-9120
Mailing address
2101 S WATKINS ST, CHATTANOOGA, TN 37404-5333
(423) 698-9120
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1000000006855
TN
305S00000X
Point of Service
1000000006855
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H445456
BUREAU OF TENNCARE
TN
Enumeration date
01/07/2011
Last updated
01/07/2011
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