Organization
CENTERSTONE OF CHATTANOOGA
Active
Organization
CENTERSTONE OF CHATTANOOGA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMIE SHULZE (CREDENTIALING SPECIALIST)
(615) 279-6746
Entity
Organization
Contact information
Practice address
807 HURRICANE CREEK RD, CHATTANOOGA, TN 37421-4517
(423) 702-0559
Mailing address
807 HURRICANE CREEK RD, CHATTANOOGA, TN 37421-4517
(423) 702-0559
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3397960
—
TN
Enumeration date
08/11/2016
Last updated
08/11/2016
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