Organization · Type 2 NPI

West Tennessee Regional Office

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Arlington, TN

NPI number 1629360375 Active

Practice location

11293 Memphis Arlington Rd
Arlington, TN 38002-7978

Call (901) 745-7573 Map

Fax (901) 745-7468

Mailing address

P.o Box 949, 11293 Memphis Arlington Rd
Arlington, TN 38002

Specialties and licenses

Taxonomy	Code	License
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	OT1340 (TN)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

3 other providers at this address

NPI record

NPI: 1629360375
Entity type: Organization (Type 2)
Issued: May 12, 2011
Last updated: May 12, 2011
Status: Active

Other names

<unavail>
Divison for Development and Intellectual Disabilities · doing business as

Authorized official

Mrs. Anjali Vasishta, OTR/L
Occupational Therapist
(901) 745-7573

Verify this record

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.

Is this your record? How to update it.

About NPI 1629360375

West Tennessee Regional Office's National Provider Identifier is 1629360375, issued on May 12, 2011. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Arlington, TN. The record was last updated on May 12, 2011.