# SOLACE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134346661
- **Authorized official:** DR. JAN F. SHERBAK PSYD (CLINICAL DIRECTOR/OWNER)
- **Authorized official phone:** (423) 752-5207

## Contact information

- **Practice address:** 3097 BROAD ST, CHATTANOOGA, TN 37408-3093
- **Practice address phone:** (423) 752-5207
- **Practice address fax:** (423) 752-5299
- **Mailing address:** 3097 BROAD ST, CHATTANOOGA, TN 37408-3093
- **Mailing address phone:** (423) 752-5207
- **Mailing address fax:** (423) 752-5299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | Yes |

## Other

- **Enumeration date:** 04/19/2007
- **Last updated:** 01/28/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4055601 | BCBS | TN |