Provider Demographics
NPI:1629153044
Name:ABS LINCS TN, INC
Entity Type:Organization
Organization Name:ABS LINCS TN, INC
Other - Org Name:CUMBERLAND HALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:WARD
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:423-499-9007
Mailing Address - Street 1:7351 STANDIFER GAP RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-8404
Mailing Address - Country:US
Mailing Address - Phone:423-499-9007
Mailing Address - Fax:423-954-9832
Practice Address - Street 1:7351 STANDIFER GAP RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-8404
Practice Address - Country:US
Practice Address - Phone:423-499-9007
Practice Address - Fax:423-954-9832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2231283Q00000X, 323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility