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NPI Code Detail

MEDICARE: THE HEALING ARTS RESEARCH TRAINING CENTER

MEDICARE: THE HEALING ARTS RESEARCH TRAINING CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/CenterI000000002860TN

General Provider Information

NPI Number : 1538325717
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE HEALING ARTS RESEARCH TRAINING CENTER
Provider Business Mailing Address
First Line : 1384 MADISON AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-2327
Country : US
Telephone Number : 901-828-1332
Fax Number : 901-493-1103
Provider Business Practice Location Address
First Line : 1384 MADISON AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-2327
Country : US
Telephone Number : 901-828-1332
Fax Number : 901-493-1103
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. CARLTON KEITH HENDERSON
Credential : L.C.S.W.
Telephone Number : 901-493-1103
Provider Enumeration Date : 08/06/2008
Last Update Date : 08/06/2008

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