Escape | |
3476 Summer Ave Memphis TN 38122-3610 | |
(901) 736-8165 | |
Not Available |
Full Name | Escape |
---|---|
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 3476 Summer Ave, Memphis, Tennessee |
Authorized Official Name and Position | Walter M Henderson (CHEIF EXECUTIVE OFFICER) |
Authorized Official Contact | 9017368165 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Escape 6878 Mikayla Ln Cordova TN 38018-7921 Ph: (901) 736-8165 | Escape 3476 Summer Ave Memphis TN 38122-3610 Ph: (901) 736-8165 |
NPI Number | 1730513037 |
---|---|
Provider Enumeration Date | 08/22/2013 |
Last Update Date | 08/22/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730513037 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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