ORANGE GROVE CENTER INC. NPI 1760696322

NPI Information

ORANGE GROVE CENTER, INC. is an intermediate care facility mentally retarded in Chattanooga, TN. The provider is (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. ORANGE GROVE CENTER, INC. NPI is 1760696322. The provider is registered as an organization entity type.

The provider's business location address is:

916A GLENWOOD DR
CHATTANOOGA, TN
ZIP 37406-328
Phone: (423) 629-1451
Fax: (423) 624-1294

The provider's authorized official is Kyle Hauth .
The authorized official title is Executive Director and has the following contact phone number (423) 629-1451.

The CLIA number assigned to this NPI record is 44D0659114 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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