Mid South Residential Care Center

LBN: Mid South Residential Care Center
Mid South Residential Care Center is an health care organization with primary practice located at 1137 Breedlove St , Memphis TN 38107-2101. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Mid South Residential Care Center can be contacted via phone (901) 314-0146, or through Clark, Gwendolyn via phone (901) 314-0146.

Contact Information

Primary practice address
1137 Breedlove St Memphis TN 38107-2101
Phone: (901) 314-0146
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Clark, Gwendolyn
Phone: (901) 314-0146

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X I000000007899 Tennessee

Profile Details

NPI number 1265737795
LBN Legal business name Mid South Residential Care Center
DBA Doing business as
Authorized official Clark, Gwendolyn
Entity Organization
Organization subpart 1 No
Enumeration date Jan 13th, 2011
Last updated Jan 13th, 2011 - 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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