Provider Demographics
NPI:1245437219
Name:LOUISE SIMMONS FAMILY CENTERS INC
Entity type:Organization
Organization Name:LOUISE SIMMONS FAMILY CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-624-2543
Mailing Address - Street 1:2312 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-3713
Mailing Address - Country:US
Mailing Address - Phone:423-624-2543
Mailing Address - Fax:423-624-1824
Practice Address - Street 1:2312 UNION AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3713
Practice Address - Country:US
Practice Address - Phone:423-624-2543
Practice Address - Fax:423-624-1824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNT000183Medicaid