Organization
SOUTHEAST MENTAL HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OWEN EUGENE LAWRENCE MA (EXECUTIVE DIRECTOR)
(901) 369-1420
Entity
Organization
Contact information
Practice address
2579 DOUGLASS AVE, SOUTHEAST MENTAL HEALTH CENTER, MEMPHIS, TN 38114-2532
(901) 369-1484
(901) 312-7572
Mailing address
3810 WINCHESTER RD, SOUTHEAST MENTAL HEALTH CENTER, MEMPHIS, TN 38118-6045
(901) 369-1420
(901) 369-1433
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
762
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
399596
—
TN
Enumeration date
12/19/2006
Last updated
08/22/2020
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