Healthcare Provider Details

I. General information

NPI: 1245003425
Provider Name (Legal Business Name): BRAINRANGER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2023
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6857 MOUNTAIN VIEW RD STE 100
OOLTEWAH TN
37363-6561
US

IV. Provider business mailing address

9004 MISTY MOOR LN
OOLTEWAH TN
37363-6808
US

V. Phone/Fax

Practice location:
  • Phone: 423-315-2222
  • Fax: 888-231-1141
Mailing address:
  • Phone: 423-315-2222
  • Fax: 888-231-1141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER LEE ATKINS
Title or Position: CEO
Credential: LCSW
Phone: 423-315-2222