Healthcare Provider Details

I. General information

NPI: 1457347809
Provider Name (Legal Business Name): EAST CHATTANOOGA EARLY INTERVENTION PRESCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 BENTON AVE
CHATTANOOGA TN
37406-3621
US

IV. Provider business mailing address

2701 BENTON AVE
CHATTANOOGA TN
37406-3621
US

V. Phone/Fax

Practice location:
  • Phone: 423-496-9648
  • Fax:
Mailing address:
  • Phone: 423-496-9648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM3000X
TaxonomyMedically Fragile Infants and Children Day Care
License Number
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateTN

VIII. Authorized Official

Name: CASSANDRA RENEE WOODRUFF
Title or Position: DIRECTOR
Credential:
Phone: 423-493-9648