Healthcare Provider Details

I. General information

NPI: 1336248061
Provider Name (Legal Business Name): COUNCIL FOR ALCOHOL AND DRUG ABUSE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 SPEARS AVE
CHATTANOOGA TN
37405-3840
US

IV. Provider business mailing address

207 SPEARS AVE P.O. BOX 4797
CHATTANOOGA TN
37405-3840
US

V. Phone/Fax

Practice location:
  • Phone: 423-756-7644
  • Fax: 723-756-7646
Mailing address:
  • Phone: 423-756-7644
  • Fax: 723-756-7646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number0000000093
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number0000000095
License Number StateTN

VIII. Authorized Official

Name: MR. JAMES C SHAW
Title or Position: DIRECTOR OF BUSINESS AND FINANCE
Credential: MBA
Phone: 423-756-7644