Healthcare Provider Details

I. General information

NPI: 1083414437
Provider Name (Legal Business Name): SELECTED MOTION GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2025
Last Update Date: 03/15/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 UNION AVE STE 1000
MEMPHIS TN
38104-7501
US

IV. Provider business mailing address

1331 UNION AVE STE 1000
MEMPHIS TN
38104-7501
US

V. Phone/Fax

Practice location:
  • Phone: 901-592-1000
  • Fax: 901-290-0646
Mailing address:
  • Phone: 901-592-1000
  • Fax: 901-290-0646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. DARRYL D AYERS
Title or Position: CEO
Credential:
Phone: 901-530-0797