Healthcare Provider Details

I. General information

NPI: 1316945322
Provider Name (Legal Business Name): DDMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 POPLAR AVE SUITE 718
MEMPHIS TN
38157-0101
US

IV. Provider business mailing address

5050 POPLAR AVE SUITE 718
MEMPHIS TN
38157-0101
US

V. Phone/Fax

Practice location:
  • Phone: 901-767-1455
  • Fax: 901-767-1409
Mailing address:
  • Phone: 901-767-1455
  • Fax: 901-767-1409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TERRY SWATLEY
Title or Position: PRESIDENT
Credential:
Phone: 901-767-1455