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Organization
MATURECARE OF STANDIFER PLACE LLC
Active
Organization
MATURECARE OF STANDIFER PLACE LLC
Active
Parent organization
SALT FOUNDATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
SALT FOUNDATION
Authorized official
JOHN STRAWN (ADMINISTRATOR)
(423) 490-1599
Entity
Organization
Contact information
Practice address
2626 WALKER RD, CHATTANOOGA, TN 37421-1116
(423) 490-1599
Mailing address
2626 WALKER RD, CHATTANOOGA, TN 37421-1116
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4041443
PPO
—
Enumeration date
02/12/2007
Last updated
01/21/2008
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