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General NPI Number Information
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NPI Number | 1144746645
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Entity Type | Organization
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Legal Business Name | MOBILITY AT HOME LLC
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6307 E BRAINERD RD
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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 | 423-531-4663
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Fax | 423-531-4664
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Provider Business Mailing Address
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Address Line | 6307 E BRAINERD RD
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City | CHATTANOOGA
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State | TN
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Zip | 37421-3939
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Country | US
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Telephone | 423-531-4663
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Fax | 423-531-4664
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Authorized Official
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Title or Position | MANAGING EMPLOYEE
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Name | MRS. LORI BETH WILLIAMS
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Credential | LMSW
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Telephone | 423-531-4663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 68600
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License Number State | TN
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