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General NPI Number Information
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NPI Number | 1851997654
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Entity Type | Organization
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Legal Business Name | ESTELLAS HOME CARE INC
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 1082 VOLLINTINE AVE
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City | MEMPHIS
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State | TN
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Zip | 38107-2823
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Country | US
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Telephone | 901-406-8473
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Fax | 901-526-8473
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Provider Business Mailing Address
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Address Line | 809 GARLAND ST
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City | MEMPHIS
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State | TN
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Zip | 38107-4432
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Country | US
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Telephone | 901-643-3556
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Fax | 901-526-8473
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Authorized Official
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Title or Position | OWNER
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Name | STELLA TERESA LITTLEJOHN
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Credential |
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Telephone | 901-406-8473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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