Organization
THE MCLEOD HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATOYA MCLEOD CTRS (SUPPORT COORDINATOR)
(423) 400-0107
Entity
Organization
Contact information
Practice address
4704 KENWOOD AVE, CHATTANOOGA, TN 37411-3805
(423) 505-7866
Mailing address
4704 KENWOOD AVE, CHATTANOOGA, TN 37411-3805
(423) 505-7866
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
11/27/2016
Last updated
11/27/2016
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