MEDICARE: LIFE HELP PSYCHIATRY & COACHING LLC

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
1	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician

General Provider Information

NPI Number	:	1669746723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE HELP PSYCHIATRY & COACHING LLC

Provider Business Mailing Address
First Line	:	3249 HOMEWOOD DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38128-4409
Country	:	US
Telephone Number	:	901-486-8800
Fax Number	:	901-531-8103

Provider Business Practice Location Address
First Line	:	3249 HOMEWOOD DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38128-4409
Country	:	US
Telephone Number	:	901-486-8800
Fax Number	:	901-531-8103

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	JACQUELINE D MOSES
Credential	:	M.D.
Telephone Number	:	901-486-8800

Provider Enumeration Date	:	03/06/2012
Last Update Date	:	03/06/2012

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