Provider Demographics
NPI:1265821789
Name:CHANCE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:CHANCE ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNER
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:615-588-1624
Mailing Address - Street 1:104 THIRD AVE E
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37030-1471
Mailing Address - Country:US
Mailing Address - Phone:615-588-1624
Mailing Address - Fax:615-588-1654
Practice Address - Street 1:104 THIRD AVE E
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030-1471
Practice Address - Country:US
Practice Address - Phone:615-588-1624
Practice Address - Fax:615-588-1654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2279251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health