Organization
PATRICKGRAPEVINE
Active
Organization
PATRICKGRAPEVINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COLEMAN THOMPSON (PRESIDENT CEO)
(901) 550-1011
Entity
Organization
Contact information
Practice address
1833 SOUTH THIRD STREET, MEMPHIS, TN 38109
(901) 550-1011
Mailing address
1833 S 3RD ST, MEMPHIS, TN 38109-7717
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0000000475
TN
Other
Enumeration date
06/26/2008
Last updated
06/26/2008
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