# CALICO DEVELOPMENTAL SERVICES INC

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

## Provider details

- **NPI number:** 1629611637
- **Authorized official:** STACEY BUCHANNON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (404) 819-1611

## Contact information

- **Practice address:** 3874 VISCOUNT AVE STE 7, MEMPHIS, TN 38118-6000
- **Practice address phone:** (615) 968-0447
- **Practice address fax:** (901) 417-8113
- **Mailing address:** 3874 VISCOUNT AVE STE 7, MEMPHIS, TN 38118-6000
- **Mailing address phone:** (615) 968-0447
- **Mailing address fax:** (901) 417-8113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |
| 347C00000X | Private Vehicle | — | NULL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 10/22/2019
- **Last updated:** 10/22/2019