NPI 1245746171

Davis Supportive Living Home INC.

Organisation Adult Care Home Facility Chattanooga, TN

Practice location

Address: 1106 Duncan Avenue, Chattanooga, TN 37404
Phone: (423) 825-5210
Fax: (423) 821-5071
Mailing address: 4627 Kirkland Ave, Chattanooga, TN 37410

Authorised official

Name: Lubron Davis
Title: Administrator
Phone: (423) 825-5210

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 0000000291 (TN)

Other Custodial Care Facility providers in Tennessee →

Registry record

NPI: 1245746171
Entity type: Organization
NPI issued: 14 Dec 2017
Record last updated: 14 Dec 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.