Healthcare Provider Details

I. General information

NPI: 1912482043
Provider Name (Legal Business Name): FOR THE PEOPLE BY THE PEOPLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 09/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 RACINE ST STE 105
MEMPHIS TN
38111-2729
US

IV. Provider business mailing address

119 RACINE ST STE 105
MEMPHIS TN
38111-2729
US

V. Phone/Fax

Practice location:
  • Phone: 901-321-5774
  • Fax: 901-443-5089
Mailing address:
  • Phone: 901-321-5774
  • Fax: 901-443-5089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MISS SHADONNA ROSHAWN PERRY
Title or Position: DIRECTOR
Credential:
Phone: 901-321-5774