=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558239350
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RONALD MCDONALD HOUSE CHARITIES OF GREATER CHATTANOOGA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2025
-----------------------------------------------------
Last Update Date | 10/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 CENTRAL AVE
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37403-1506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-719-0701
-----------------------------------------------------
Fax | 423-719-0669
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 CENTRAL AVE
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37403-1506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-719-0701
-----------------------------------------------------
Fax | 423-719-0669
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | MIKE BROWN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 423-719-0731
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174200000X
-----------------------------------------------------
Taxonomy Name | Meals Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 177F00000X
-----------------------------------------------------
Taxonomy Name | Lodging Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------