Organization
DAVIS SUPPORTIVE LIVING HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUBRON DAVIS (ADMINISTRATOR)
(423) 825-5210
Entity
Organization
Contact information
Practice address
1106 DUNCAN AVENUE, CHATTANOOGA, TN 37404
(423) 825-5210
(423) 821-5071
Mailing address
4627 KIRKLAND AVE, CHATTANOOGA, TN 37410
(423) 825-5210
(423) 821-5071
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
0000000291
TN
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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