Organization
SOUTHEAST MENTAL HEALTH CENTER, INC
Active
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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