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General NPI Number Information
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NPI Number | 1124805858
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Entity Type | Organization
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Legal Business Name | CARRIES'S ASSISTED LIVING FACILITY LLC
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 3968 N TREZEVANT ST
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City | MEMPHIS
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State | TN
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Zip | 38127-4133
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Country | US
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Telephone | 901-250-8779
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Fax |
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Provider Business Mailing Address
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Address Line | 2432 HERNANDO RD
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City | MEMPHIS
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State | TN
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Zip | 38106-8037
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Country | US
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Telephone | 901-250-8779
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ALYSON PAYNE
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Credential |
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Telephone | 901-355-2206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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