Healthcare Provider Details

I. General information

NPI: 1265564454
Provider Name (Legal Business Name): JOSHUA'S HOUSE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1656 LAMAR AVE
MEMPHIS TN
38114-1642
US

IV. Provider business mailing address

PO BOX 140596
MEMPHIS TN
38114-0596
US

V. Phone/Fax

Practice location:
  • Phone: 901-473-9221
  • Fax: 901-405-1319
Mailing address:
  • Phone: 901-473-9221
  • Fax: 901-405-1319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateTN

VIII. Authorized Official

Name: MRS. RHONDA FERGUSON
Title or Position: CEO
Credential: MASTER'S LEVEL
Phone: 901-473-9221