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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. HAROLD EDWARD BATES SR. MS, LADAC (COUNSELOR)
(901) 347-3037
Entity
Organization

Contact information

Practice address
5830 MOUNT MORIAH RD STE 10, MEMPHIS, TN 38115-1628
(901) 347-3037
Mailing address
5830 MOUNT MORIAH RD STE 10, MEMPHIS, TN 38115-1628
(901) 347-3037

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LDC0000000619
TN

Other

Enumeration date
02/03/2016
Last updated
02/03/2016
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