Healthcare Provider Details

I. General information

NPI: 1841137726
Provider Name (Legal Business Name): VELMA'S GROUP HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3638 RUSSELWOOD DR
MEMPHIS TN
38128-5242
US

IV. Provider business mailing address

3409 COLEMAN RD 3638 RUSSELWOOD DRIVE
MEMPHIS TN
38128-3619
US

V. Phone/Fax

Practice location:
  • Phone: 901-502-9346
  • Fax:
Mailing address:
  • Phone: 901-502-9346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH WARD
Title or Position: OWNER
Credential: CARE GIVER
Phone: 901-502-9346