Organization
KIARAD ENTERPRISES SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN O JOHNSON (PRESIDENT/OWNER)
(901) 730-0368
Entity
Organization
Contact information
Practice address
3994 EDENBURG DR, MEMPHIS, TN 38127-4112
(901) 730-0368
(901) 531-8398
Mailing address
3554 CARNEY ST, MEMPHIS, TN 38127-5032
(901) 730-0368
(901) 531-8398
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/20/2019
Last updated
07/09/2019
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