Healthcare Provider Details

I. General information

NPI: 1821922865
Provider Name (Legal Business Name): KIRBY GATE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6480 QUINCE RD
MEMPHIS TN
38119-8222
US

IV. Provider business mailing address

6480 QUINCE RD
MEMPHIS TN
38119-8222
US

V. Phone/Fax

Practice location:
  • Phone: 931-753-3449
  • Fax:
Mailing address:
  • Phone: 901-753-3449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MAX ECHUZ
Title or Position: OWNER
Credential:
Phone: 347-946-5945