Provider Demographics
NPI:1265680169
Name:GREATER CHATTANOOGA CHRISTIAN SERVICES
Entity Type:Organization
Organization Name:GREATER CHATTANOOGA CHRISTIAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:
Authorized Official - Last Name:KILPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:423-499-9535
Mailing Address - Street 1:PO BOX 16396
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-0396
Mailing Address - Country:US
Mailing Address - Phone:423-499-9535
Mailing Address - Fax:423-499-0335
Practice Address - Street 1:6816 TY HI DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1456
Practice Address - Country:US
Practice Address - Phone:423-499-9535
Practice Address - Fax:423-499-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable