Healthcare Provider Details

I. General information

NPI: 1124039961
Provider Name (Legal Business Name): ABS LINCS TN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7351 STANDIFER GAP RD
CHATTANOOGA TN
37421-8404
US

IV. Provider business mailing address

7351 COURAGE WAY
CHATTANOOGA TN
37421-8404
US

V. Phone/Fax

Practice location:
  • Phone: 423-499-9007
  • Fax: 423-499-9757
Mailing address:
  • Phone: 423-499-9007
  • Fax: 423-499-9757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License NumberL 2(16)M2-115-1103
License Number StateTN

VIII. Authorized Official

Name: MS. EUREKA C. DAYE
Title or Position: CHIEF EXECUTIVE OFFICE
Credential: BA, MA, MS
Phone: 423-499-9007