# BLACK HOLDINGS GROUP,LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568861037
- **Authorized official:** DR. AUDRIA KAYE BLACK MD (PHYSICIAN)
- **Authorized official phone:** (901) 755-6280

## Contact information

- **Practice address:** 8000 CENTERVIEW PKWY, SUITE 104, CORDOVA, TN 38018-4227
- **Practice address phone:** (901) 755-6280
- **Practice address fax:** (901) 755-7897
- **Mailing address:** PO BOX 38175, GERMANTOWN, TN 38183-0175
- **Mailing address phone:** (901) 755-6280
- **Mailing address fax:** (901) 755-7897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | 36627 | TN | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 36627 | TN | Yes |

## Other

- **Enumeration date:** 08/20/2014
- **Last updated:** 08/20/2014