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General NPI Number Information
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NPI Number | 1447417597
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE CHOICE
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 1701 S MARKET ST
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City | CHATTANOOGA
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State | TN
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Zip | 37408-1813
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Country | US
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Telephone | 423-752-0605
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Fax | 423-752-0608
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Provider Business Mailing Address
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Address Line | 1701 S MARKET ST
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City | CHATTANOOGA
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State | TN
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Zip | 37408-1813
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Country | US
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Telephone | 423-752-0605
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Fax | 423-752-0608
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Authorized Official
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Title or Position | CEO
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Name | MS. KETURA ODEN
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Credential | LPN
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Telephone | 931-381-2841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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