Healthcare Provider Details

I. General information

NPI: 1609286228
Provider Name (Legal Business Name): A LITTLE LOVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3877 WINCHESTER RD STE 6B
MEMPHIS TN
38118-6055
US

IV. Provider business mailing address

3877 WINCHESTER RD STE 6B
MEMPHIS TN
38118-6055
US

V. Phone/Fax

Practice location:
  • Phone: 901-318-8318
  • Fax: 901-435-6574
Mailing address:
  • Phone: 901-318-8318
  • Fax: 901-435-6574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberI000000014357
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberI000000014357
License Number StateTN

VIII. Authorized Official

Name: MS. SHAQUINTA TOMARA ANDERSON
Title or Position: OWNER
Credential:
Phone: 901-314-8318