| Coffee Associates A Medical Management Organization, Llc | |
|
482 Interstate Dr Suite D Manchester TN 37355-3485 | |
| (931) 444-1000 | |
| (931) 450-8256 |
| Full Name | Coffee Associates A Medical Management Organization, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 482 Interstate Dr, Manchester, Tennessee |
| Authorized Official Name and Position | Joseph Clifton Chester (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9314441000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coffee Associates A Medical Management Organization, Llc 482 Interstate Dr Suite D Manchester TN 37355-3485 Ph: (931) 444-1000 | Coffee Associates A Medical Management Organization, Llc 482 Interstate Dr Suite D Manchester TN 37355-3485 Ph: (931) 444-1000 |
| NPI Number | 1760926075 |
|---|---|
| Provider Enumeration Date | 12/06/2016 |
| Last Update Date | 12/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760926075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 3079 (Tennessee) | Secondary |
| 1041C0700X | Social Worker - Clinical | LSW000000003614 (Tennessee) | Primary |
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