Broken Healer Home

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

BROKEN HEALER HOME

Practice address

2423 Cedar Creek Dr
Chattanooga, TN 37421-2006

Phone

(423) 242-8551

NPI assigned

Mar 7, 2024

Last updated

Mar 11, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nirva Ache

Title

Ceo

Phone

(423) 242-8551

Specialties & licenses 1

Addresses

Other names 1

• BROKEN HEALER HOME Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1255199949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 RYNES RD",
            "city": "DECATUR",
            "state": "TN",
            "postal_code": "373227420",
            "telephone_number": "423-242-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 CEDAR CREEK DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212006",
            "telephone_number": "423-242-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKEN HEALER HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "ACHE",
        "authorized_official_first_name": "NIRVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-242-8551"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROKEN HEALER HOME",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.