Organization · Type 2 NPI

Mid South Supportive Living, LLC

Intellectual and/or Developmental Disabilities Residential Treatment Facility · Memphis, TN

NPI number 1679604458 Active

Practice location

2600 Poplar Ave, Suite 223
Memphis, TN 38112-3851

Call (901) 458-1181 Map

Fax (901) 324-9669

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary 320600000XL 3(20)M2-046-6201 (TN)

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

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About NPI 1679604458

Mid South Supportive Living, LLC's National Provider Identifier is 1679604458, issued on Mar 7, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Memphis, TN. The record was last updated on Sep 3, 2009.