Provider Demographics
NPI:1649776691
Name:SERIOUS HEALTH SERVICES
Entity Type:Organization
Organization Name:SERIOUS HEALTH SERVICES
Other - Org Name:SERIOUS HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETTINA
Authorized Official - Middle Name:GIDEON
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-400-3644
Mailing Address - Street 1:715 CHERRY ST STE 207
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-1929
Mailing Address - Country:US
Mailing Address - Phone:423-777-0097
Mailing Address - Fax:
Practice Address - Street 1:715 CHERRY ST STE 207
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-1929
Practice Address - Country:US
Practice Address - Phone:423-777-0097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service