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General NPI Number Information
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NPI Number | 1952745127
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Entity Type | Organization
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Legal Business Name | TENNESSEE LEARNING ACADEMY
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Dates
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Enumeration Date | 04/18/2013
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Last Update Date | 04/18/2013
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Provider Practice Location Address
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Address Line | 2491 JOY LN
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City | MEMPHIS
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State | TN
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Zip | 38114-6088
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Country | US
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Telephone | 901-273-4336
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 753553
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City | MEMPHIS
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State | TN
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Zip | 38175-3553
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Country | US
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Telephone | 901-273-4336
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. SHARON PAIGE
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Credential |
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Telephone | 901-273-4336
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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 | SO/C0349
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License Number State | TN
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