MEDICARE: ADVANCED BEHAVIORAL-EMOTIONAL CARE SERVICES, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1609398312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED BEHAVIORAL-EMOTIONAL CARE SERVICES, LLC.

Provider Business Mailing Address
First Line	:	200 W ML KING BLVD STE 1000
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37402-2571
Country	:	US
Telephone Number	:	704-771-4633
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W ML KING BLVD STE 1000
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37402-2571
Country	:	US
Telephone Number	:	704-771-4633
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	MR. DAVID CUMBERLANDER
Credential	:
Telephone Number	:	704-771-4633

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	07/21/2022

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