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General NPI Number Information
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NPI Number | 1467092932
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Entity Type | Organization
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Legal Business Name | MSHN ENTERPRISES LLC
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 2056 FLETCHER CREEK DR STE 101
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City | MEMPHIS
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State | TN
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Zip | 38133-7060
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Country | US
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Telephone | 901-410-9062
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Fax |
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Provider Business Mailing Address
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Address Line | 2057 FLETCHER CREEK DR
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City | MEMPHIS
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State | TN
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Zip | 38133-7059
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Country | US
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Telephone | 901-825-8972
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Fax | 901-729-6169
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Authorized Official
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Title or Position | CIO
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Name | CHRISTOPHER GLENN STEPHENSON
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Credential |
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Telephone | 901-410-9062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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