Organization
MATURECARE OF STANDIFER PLACE LLC
Active
Parent organization
SALT FOUNDATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
SALT FOUNDATION
Authorized official
JOHN STRAWN (ADMINISTRATOR)
(423) 490-1599
Entity
Organization
Contact information
Practice address
2626 WALKER RD, CHATTANOOGA, TN 37421-1116
(423) 490-1599
Mailing address
2626 WALKER RD, CHATTANOOGA, TN 37421-1116
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4041443
PPO
—
Enumeration date
02/12/2007
Last updated
01/21/2008
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