Healthcare Provider Details

I. General information

NPI: 1851997654
Provider Name (Legal Business Name): ESTELLAS HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2020
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1082 VOLLINTINE AVE
MEMPHIS TN
38107-2823
US

IV. Provider business mailing address

809 GARLAND ST
MEMPHIS TN
38107-4432
US

V. Phone/Fax

Practice location:
  • Phone: 901-406-8473
  • Fax: 901-526-8473
Mailing address:
  • Phone: 901-643-3556
  • Fax: 901-526-8473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: STELLA TERESA LITTLEJOHN
Title or Position: OWNER
Credential:
Phone: 901-406-8473