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General NPI Number Information
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NPI Number | 1083105803
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Entity Type | Organization
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Legal Business Name | TRAUMA AND ADDICTION RECOVERY CENTER
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 05/29/2018
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Provider Practice Location Address
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Address Line | 6727 HERITAGE BUSINESS CT STE 718
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City | CHATTANOOGA
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State | TN
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Zip | 37421
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Country | US
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Telephone | 423-240-0581
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Fax |
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Provider Business Mailing Address
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Address Line | 6727 HERITAGE BUSINESS CT STE 718
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2597
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Country | US
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Telephone | 423-240-0581
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | BECCA DAVIS
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Credential | LPC-MHSP
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Telephone | 615-486-9801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 3244
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License Number State | TN
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