MEDICARE: SHELBY RESIDENTIAL & VOCATIONAL SERVICES, INC.

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	315P00000X	Intellectual Disabilities Intermediate Care Facility	L323-067-6613	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942457262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHELBY RESIDENTIAL & VOCATIONAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	3971 KNIGHT ARNOLD RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38118-3004
Country	:	US
Telephone Number	:	901-869-7787
Fax Number	:	901-322-6391

Provider Business Practice Location Address
First Line	:	1735 WHITNEY AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38127-8048
Country	:	US
Telephone Number	:	901-358-3360
Fax Number	:	901-312-9906

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	SHANNON DURBIN
Credential	:
Telephone Number	:	901-821-1067

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	05/02/2024

Similar Medicare Providers

1467924837 — CL TRANSPORTATION SVCS INC
Practice Location Address:

2931 WATERVIEW CV
MEMPHIS, TN
38119-8048

Practice Phone: 901-413-6688
Practice Fax:

1891626313 — SHAWANNAH BROWN ELDER CARE
Practice Location Address:

972 CARROLTON RD
MEMPHIS, TN
38127-3710

Practice Phone: 901-671-6607
Practice Fax:

1588595276 — ANJAIL NEWELL
Practice Location Address:

969 FRAYSER BLVD
MEMPHIS, TN
38127-5977

Practice Phone: 901-842-3162
Practice Fax:

1336149558 — DR. RICHARD A NELSON MD
Practice Location Address:

969 FRAYSER BLVD
MEMPHIS, TN
38127-5977

Practice Phone: 901-701-2540
Practice Fax: 901-260-8449

1790778991 — DR. ROBERT A DECOLLI JR. D.O
Practice Location Address:

3360 N WATKINS ST
MEMPHIS, TN
38127-6405

Practice Phone: 901-401-7150
Practice Fax: 901-347-1285

1982697058 — DR. DAVID KEITH TALLEY O.D.
Practice Location Address:

2070 WHITNEY AVE
MEMPHIS, TN
38127-9014

Practice Phone: 901-357-0371
Practice Fax: 901-358-7574

Directions to “SHELBY RESIDENTIAL & VOCATIONAL SERVICES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.