Organization
SOUTHEAST COMMUNITY SERVICE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RESHONDA SHANAY GOINS (COORDINATOR)
(423) 634-6966
Entity
Organization
Contact information
Practice address
1501 RIVERSIDE DR, 105, CHATTANOOGA, TN 37406-4309
(423) 634-6966
(423) 634-6120
Mailing address
1501 RIVERSIDE DR, 105, CHATTANOOGA, TN 37406-4309
(423) 634-6966
(423) 634-6120
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T000208
—
TN
Enumeration date
01/30/2007
Last updated
07/13/2007
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