Healthcare Provider Details

I. General information

NPI: 1669746723
Provider Name (Legal Business Name): LIFE HELP PSYCHIATRY & COACHING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2012
Last Update Date: 03/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3249 HOMEWOOD DR
MEMPHIS TN
38128-4409
US

IV. Provider business mailing address

3249 HOMEWOOD DR
MEMPHIS TN
38128-4409
US

V. Phone/Fax

Practice location:
  • Phone: 901-486-8800
  • Fax: 901-531-8103
Mailing address:
  • Phone: 901-486-8800
  • Fax: 901-531-8103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JACQUELINE D MOSES
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 901-486-8800