Organization · Type 2 NPI

Shelby Residential & Vocational Services, Inc.

Intellectual Disabilities Intermediate Care Facility · Memphis, TN

NPI number 1396992608 Active

Practice location

4101 Tessland Rd
Memphis, TN 38128-2201

Call (901) 377-3873 Map

Fax (901) 312-9906

Mailing address

3971 Knight Arnold Rd
Memphis, TN 38118-3004

Specialties and licenses

Taxonomy	Code	License
Intellectual Disabilities Intermediate Care Facility Primary	315P00000X	L323-067-6612 (TN)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

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NPI record

NPI: 1396992608
Entity type: Organization (Type 2)
Issued: Aug 19, 2008
Last updated: May 2, 2024
Status: Active
Subpart: Yes of Shelby Residential & Vocational Services, Inc.

Other names

<unavail>
Tessland · doing business as
Tessland · doing business as

Authorized official

Shannon Durbin
Executive Director
(901) 821-1067

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1396992608

Shelby Residential & Vocational Services, Inc.'s National Provider Identifier is 1396992608, issued on Aug 19, 2008. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Memphis, TN. The record was last updated on May 2, 2024.