Southeast Community Service Agency

LBN: Southeast Community Service Agency
Southeast Community Service Agency is an health care organization with primary practice located at 1501 Riverside Dr 105, Chattanooga TN 37406-4309. The organization recently has only one registered license in Transportation Services / Transportation Broker, which is considered as the primary health care specialty. Southeast Community Service Agency can be contacted via phone (423) 634-6966, or through Goins, Reshonda Shanay via phone (423) 634-6966.

Contact Information

Primary practice address
1501 Riverside Dr 105 Chattanooga TN 37406-4309
Phone: (423) 634-6966
Fax: (423) 634-6120
Website:
Map and Directions
Authorized official contact:
Name: Goins, Reshonda Shanay
Phone: (423) 634-6966

Health care specialties

SpecialtyCodeLicense #State
Transportation Services / Transportation Broker 347E00000X

Profile Details

NPI number 1639215171
LBN Legal business name Southeast Community Service Agency
DBA Doing business as
Authorized official Goins, Reshonda Shanay
Entity Organization
Organization subpart 1 No
Enumeration date Jan 30th, 2007
Last updated Jul 13th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639215171 NPPES
Tennessee MEDICAID T000208

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