Healthcare Provider Details

I. General information

NPI: 1558239350
Provider Name (Legal Business Name): RONALD MCDONALD HOUSE CHARITIES OF GREATER CHATTANOOGA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CENTRAL AVE
CHATTANOOGA TN
37403-1506
US

IV. Provider business mailing address

200 CENTRAL AVE
CHATTANOOGA TN
37403-1506
US

V. Phone/Fax

Practice location:
  • Phone: 423-719-0701
  • Fax: 423-719-0669
Mailing address:
  • Phone: 423-719-0701
  • Fax: 423-719-0669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: MIKE BROWN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 423-719-0731