Provider Demographics
NPI:1477745461
Name:PHP CARITEN ASSIST
Entity Type:Organization
Organization Name:PHP CARITEN ASSIST
Other - Org Name:CARITEN ASSIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BEHAVIORAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:DAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MHSP
Authorized Official - Phone:865-531-5346
Mailing Address - Street 1:220 FORT SANDERS WEST BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3398
Mailing Address - Country:US
Mailing Address - Phone:865-531-4500
Mailing Address - Fax:865-531-4584
Practice Address - Street 1:220 FORT SANDERS WEST BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3398
Practice Address - Country:US
Practice Address - Phone:865-531-4500
Practice Address - Fax:865-531-4584
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHP CARITEN ASSIST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty