DAVIS SUPPORTIVE LIVING HOME INC.


Address: 1106 Duncan Avenue, Chattanooga, TN 37404
Phone: 4238255210

DAVIS SUPPORTIVE LIVING HOME INC. (NPI# 1245746171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245746171
Entity Type Organization
Organization Name DAVIS SUPPORTIVE LIVING HOME INC.
Practice Address 1106 Duncan Avenue
Chattanooga
TN 37404
Mailing Address 4627 Kirkland Ave
Chattanooga
TN 37410
Practice Telephone 4238255210
Practice Fax Number 4238215071
Mailing Telephone 4238255210
Mailing Fax Number 4238215071
Enumeration Date 2017-12-14
Last Update Date 2017-12-14
Authorized Official Name LUBRON DAVIS (ADMINISTRATOR)
Authorized Official Telephone 4238255210
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 311ZA0620X Custodial Care Facility
Specialization: Adult Care Home
0000000291 TN Nursing & Custodial Care Facilities

Office Location

Street Address 1106 DUNCAN AVENUE
City CHATTANOOGA
State TN
Zip Code 37404

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1306494216 Cynthia Caffey Technician 1305 E. 28th St. Apt A, Chatta, TN 37404 2019-09-04
1851944482 Stacey Stokes Peer Specialist 1413 Bailey Ave, Chattanooga, TN 37404 2019-07-23
1306354790 Erlanger Behavioral Health, LLC Psychiatric Hospital 804 North Holtzclaw Avenue, Chattanooga, TN 37404 2018-01-19
1124544762 Rachael Anne Maciver Nurse Practitioner 1909 South Willow Street, Chattanooga, TN 37404 2017-08-15
1447796214 Esli Castillo Nurse Practitioner 281 N.lyerly St., Suite 200, Chattanooga, TN 37404 2017-01-17
1922542158 Natasha Elliott Community Health Worker 2804 Cannon Ave, Chattanooga, TN 37404 2016-12-07
1730630153 Jonathan Easter Taxi 1611 Anderson Avenue, Apt A, Chattanooga, TN 37404 2016-10-20
1477946143 Thomas Jereme Holcomb Nurse Practitioner 281 N. Lyerly St, Suite 200, Chattanooga, TN 37404 2015-03-05
1922426709 Sarah Mccary Baker Internal Medicine 605 Glenwood Drive, Suite 300, Chattanooga Internal Medicine Group, Chattanooga, TN 37404 2014-03-31
1124458450 Cantrell Home, Inc. Non-emergency Medical Transport (VAN) 2300 Chamberlain Avenue, Chattanooga, TN 37404 2013-11-22
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Taxonomy Information

Taxonomy Code 311ZA0620X
Grouping Nursing & Custodial Care Facilities
Classification Custodial Care Facility
Specialization Adult Care Home

Taxonomy Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619109063 Balm In Gilead Care Services, LLC Custodial Care Facility 1000 Oak St, Chattanooga, TN 37403-2223 2009-08-19
1134370877 On Demand Enterprises, Inc Custodial Care Facility 7003 Shallowford Rd 103, Chattanooga, TN 37421 2008-09-30
1669864625 Home Sweet Home Supportive Living Inc. Custodial Care Facility 1618 Gunbarrel Rd, 103, Chattanooga, TN 37421-4134 2015-03-02

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1265045223 Charity Baker Custodial Care Facility 677 Westwood Ave, Jackson, TN 38301-4230 2020-08-28
1790305225 Compassionate Hearts Home Care Custodial Care Facility 1910 Madison Ave # 2124, Memphis, TN 38104-2620 2020-04-24
1346710662 Kathleen Harbaugh Custodial Care Facility 526 Turkey Oak Road, Crossville, TN 38555-1502 2018-11-29
1467955542 Homevent Care LLC Custodial Care Facility 7201 Kayla Beth Ct, Ooltewah, TN 37363-6272 2018-03-14
1336660950 Philanda Britton Custodial Care Facility 3093 North Watkins St., Memphis, TN 38121 2017-07-05
1821524075 His House Custodial Care Facility 5010 Mount Zion Rd, Springfield, TN 37172-7130 2017-05-10
1962958322 Elcm Knoxville Leasing LLC Custodial Care Facility 801 E Inskip Dr, Knoxville, TN 37912-3734 2016-08-26
1366998718 Elcm Johnson City Leasing LLC Custodial Care Facility 2111 E Lakeview Dr, Johnson City, TN 37601-1890 2016-08-26
1033665492 Elcm Oak Ridge Leasing LLC Custodial Care Facility 300 Briarcliff Ave, Oak Ridge, TN 37830-8731 2016-08-26
1134582919 Boyce & Welch Logistics Transportation Custodial Care Facility 7133 Chevy Chase, Memphis, TN 38125-2610 2016-03-30
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Competitor

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City CHATTANOOGA
Zip Code 37404

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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