Healthcare Provider Details

I. General information

NPI: 1841747961
Provider Name (Legal Business Name): COMMUNITY INTEGRATED HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5618 BRAINERD ROAD
CHATTANOOGA TN
37411
US

IV. Provider business mailing address

5618 BRAINERD RD
CHATTANOOGA TN
37411-5310
US

V. Phone/Fax

Practice location:
  • Phone: 423-510-6900
  • Fax:
Mailing address:
  • Phone: 423-510-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: CHRISTI PICCIRILLI
Title or Position: ADMIN DIRECTOR
Credential:
Phone: 423-510-6900