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General NPI Number Information
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NPI Number | 1619241643
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Entity Type | Organization
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Legal Business Name | KINDRED PLACE, INC.
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 2180 UNION AVE.
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City | MEMPHIS
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State | TN
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Zip | 38104-4205
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Country | US
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Telephone | 901-276-2200
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Fax | 901-276-6828
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Provider Business Mailing Address
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Address Line | 2180 UNION AVE.
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City | MEMPHIS
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State | TN
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Zip | 38104-4205
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Country | US
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Telephone | 901-276-2200
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Fax | 901-276-6828
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Authorized Official
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Title or Position | CHIEF OF STAFF/INTERIM EXEC. DIR.
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Name | MS. PAM MEINERS
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Credential |
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Telephone | 901-341-7778
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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 | SO10823A
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License Number State | TN
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