Healthcare Provider Details

I. General information

NPI: 1275338691
Provider Name (Legal Business Name): IONOMICS ADULT AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6628 KIRBY MEADOWS CV
MEMPHIS TN
38115-4217
US

IV. Provider business mailing address

6628 KIRBY MEADOWS CV
MEMPHIS TN
38115-4217
US

V. Phone/Fax

Practice location:
  • Phone: 901-870-4899
  • Fax:
Mailing address:
  • Phone: 901-870-4899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: VENESSA RENEE THOMAS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 901-870-4899