| Mid-south Healthnet | |
|
5909 Shelby Oaks Drive Suite 100 Memphis TN 38134 | |
| (901) 383-9193 | |
| (901) 383-9195 |
| Full Name | Mid-south Healthnet |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5909 Shelby Oaks Drive Suite 100, Memphis, Tennessee |
| Authorized Official Name and Position | Marlin Angell (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9013839193 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-south Healthnet 5909 Shelby Oaks Drive Suite 100 Memphis TN 38134 Ph: (901) 383-9193 | Mid-south Healthnet 5909 Shelby Oaks Drive Suite 100 Memphis TN 38134 Ph: (901) 383-9193 |
| NPI Number | 1821479254 |
|---|---|
| Provider Enumeration Date | 06/11/2015 |
| Last Update Date | 06/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821479254 | NPI | - | NPPES |
| Q013314 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (Tennessee) | Secondary |
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