Healthcare Provider Details

I. General information

NPI: 1952791113
Provider Name (Legal Business Name): VALECIA CARDELL BEHOLD SENIOR ACTIVITY DAY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2015
Last Update Date: 01/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 SHALLOWFORD RD
CHATTANOOGA TN
37421-1711
US

IV. Provider business mailing address

6701 SHALLOWFORD RD
CHATTANOOGA TN
37421-1711
US

V. Phone/Fax

Practice location:
  • Phone: 423-771-7568
  • Fax:
Mailing address:
  • Phone: 423-771-7568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. VALECIA CARDELL
Title or Position: OWNER / DIRECTOR
Credential:
Phone: 423-486-2157