Healthcare Provider Details

I. General information

NPI: 1679406995
Provider Name (Legal Business Name): WEE CARE JUVENILE SUCCESS PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6870 CLUB RIDGE CIR APT 70
MEMPHIS TN
38115-7331
US

IV. Provider business mailing address

6870 CLUB RIDGE CIR APT 70
MEMPHIS TN
38115-7331
US

V. Phone/Fax

Practice location:
  • Phone: 901-715-1777
  • Fax:
Mailing address:
  • Phone: 901-715-1777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE RENEE JONES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 901-715-1777