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Organization
SHELBY RESIDENTIAL AND VOCATIONAL SERVICES
Active
Organization
SHELBY RESIDENTIAL AND VOCATIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON DURBIN (EXECUTIVE DIRECTOR)
(901) 821-1067
Entity
Organization
Contact information
Practice address
3971 KNIGHT ARNOLD RD, MEMPHIS, TN 38118-3004
(901) 869-7787
Mailing address
3971 KNIGHT ARNOLD RD, MEMPHIS, TN 38118-3004
(901) 869-7787
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
L323-066-6232
TN
315P00000X
Intellectual Disabilities Intermediate Care Facility
L323-066-6234
TN
315P00000X
Intellectual Disabilities Intermediate Care Facility
L323-066-6235
TN
315P00000X
Intellectual Disabilities Intermediate Care Facility
L323-066-6236
TN
315P00000X
Intellectual Disabilities Intermediate Care Facility
L323-066-6237
TN
315P00000X
Intellectual Disabilities Intermediate Care Facility
L323-066-6238
TN
315P00000X
Intellectual Disabilities Intermediate Care Facility
L323-066-6239
TN
315P00000X
Intellectual Disabilities Intermediate Care Facility
L323-066-6244
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7447075
—
TN
05
—
7447076
—
TN
05
—
7447077
—
TN
05
—
7447078
—
TN
05
—
7447079
—
TN
05
—
7447080
—
TN
05
—
7447081
—
TN
05
—
7447082
—
TN
Enumeration date
04/23/2007
Last updated
05/02/2024
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