Mitchell Home

LBN: Fortwood Center, Inc.
Mitchell Home is an health care organization with primary practice located at 1411 Bailey Ave , Chattanooga TN 37404-2904. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Fortwood Center, Inc. can be contacted via phone (423) 266-6751, or through Queen-Pennington, Melissa via phone (423) 266-6751.

Contact Information

Primary practice address
1411 Bailey Ave Chattanooga TN 37404-2904
Phone: (423) 266-6751
Fax: (423) 763-4650
Website:
Map and Directions
Authorized official contact:
Name: Queen-Pennington, Melissa
Phone: (423) 266-6751

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1881821056
LBN Legal business name Fortwood Center, Inc.
DBA Doing business as Mitchell Home
Authorized official Queen-Pennington, Melissa
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 16th, 2009
Last updated Jun 16th, 2009 - about 15 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 1881821056 NPPES
Tennessee MEDICAID 3399761

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