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General NPI Number Information
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NPI Number | 1821323007
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Entity Type | Organization
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Legal Business Name | WILLIAMS CARE HOME
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Dates
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Enumeration Date | 10/06/2009
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 1032 BREEDLOVE ST
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City | MEMPHIS
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State | TN
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Zip | 38107-2805
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Country | US
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Telephone | 901-384-9205
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Fax |
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Provider Business Mailing Address
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Address Line | 3805 RIDGEMONT AVE
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City | MEMPHIS
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State | TN
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Zip | 38128-1948
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Country | US
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Telephone | 901-384-9205
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SHARON WILLIAMS
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Credential |
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Telephone | 901-384-9205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | L000000004420
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License Number State | TN
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