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General NPI Number Information
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NPI Number | 1386442036
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Entity Type | Organization
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Legal Business Name | H.A.B.I.T.S 360, LLC
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 3233 PLAYERS CLUB PKWY
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City | MEMPHIS
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State | TN
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Zip | 38125-8845
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Country | US
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Telephone | 901-878-5895
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Fax | 346-205-0454
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Provider Business Mailing Address
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Address Line | 131 S CENTER ST P.O BOX 285
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City | COLLIERVILLE
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State | TN
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Zip | 38017
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Country | US
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Telephone | 901-849-9932
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Fax | 346-205-0454
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Authorized Official
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Title or Position | FNP
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Name | TIJUANA SALES
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Credential |
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Telephone | 901-878-5895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care 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 | 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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