1336248061 NPI number — COUNCIL FOR ALCOHOL AND DRUG ABUSE SERVICES, INC.

Table of content: (NPI 1336248061)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336248061 NPI number — COUNCIL FOR ALCOHOL AND DRUG ABUSE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNCIL FOR ALCOHOL AND DRUG ABUSE SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CADAS, INC.
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336248061
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
207 SPEARS AVE
Provider Second Line Business Mailing Address:
P.O. BOX 4797
Provider Business Mailing Address City Name:
CHATTANOOGA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37405-3840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-756-7644
Provider Business Mailing Address Fax Number:
723-756-7646

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
207 SPEARS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHATTANOOGA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37405-3840
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-756-7644
Provider Business Practice Location Address Fax Number:
723-756-7646
Provider Enumeration Date:
09/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHAW
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
C
Authorized Official Title or Position:
DIRECTOR OF BUSINESS AND FINANCE
Authorized Official Telephone Number:
423-756-7644

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  0000000093 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3245S0500X , with the licence number: 0000000095 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)