Organization
ALEXIAN BROTHERS PACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRISS GRANT (DIR.PLANNING AND COMMUNICATION)
(423) 698-0802
Entity
Organization
Contact information
Practice address
425 CUMBERLAND ST STE 110, CHATTANOOGA, TN 37404-1909
(423) 495-9126
(423) 495-9145
Mailing address
425 CUMBERLAND ST STE 110, CHATTANOOGA, TN 37404-1909
(423) 495-9126
(423) 495-9145
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BSW0000000500
DIVISION OF HEALTH RELATED BOARDS
TN
Enumeration date
07/30/2012
Last updated
07/30/2012
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