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General NPI Number Information
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NPI Number | 1073135059
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Entity Type | Organization
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Legal Business Name | KNOWLEDGE QUEST
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 990 COLLEGE PARK DR STE 104
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City | MEMPHIS
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State | TN
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Zip | 38126-6519
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Country | US
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Telephone | 901-942-1512
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2119
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City | MEMPHIS
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State | TN
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Zip | 38101-2119
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Country | US
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Telephone | 901-942-1512
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST/SOCIAL WORKER
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Name | LABRENDA THOMAS
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Credential | LCSW
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Telephone | 501-837-4526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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