MEDICARE: KIRBY GATE 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1821922865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIRBY GATE LLC

Provider Business Mailing Address
First Line	:	6480 QUINCE RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-8222
Country	:	US
Telephone Number	:	901-753-3449
Fax Number	:

Provider Business Practice Location Address
First Line	:	6480 QUINCE RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-8222
Country	:	US
Telephone Number	:	931-753-3449
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAX ECHUZ
Credential	:
Telephone Number	:	347-946-5945

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “KIRBY GATE LLC ” Practice Location

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