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General NPI Number Information
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NPI Number | 1366553794
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Entity Type | Organization
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Legal Business Name | CHAISSON CREATIVE CONSULTING, INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 09/27/2009
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Provider Practice Location Address
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Address Line | 3321 COTTON BALE CV
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City | MEMPHIS
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State | TN
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Zip | 38119-8971
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Country | US
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Telephone | 901-679-9458
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Fax | 901-759-4772
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Provider Business Mailing Address
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Address Line | 3321 COTTON BALE CV
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City | MEMPHIS
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State | TN
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Zip | 38119-8971
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Country | US
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Telephone | 901-679-9458
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Fax | 901-759-4772
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Authorized Official
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Title or Position | OWNER
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Name | MR. RONALD J CHAISSON II
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Credential | BA
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Telephone | 901-679-9458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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