Organization
WR COMMUNITY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK DWANE RICHARDS (CEO)
(901) 624-0371
Entity
Organization
Contact information
Practice address
8316 MACON TERRACE, SUITE 102, CORDOVA, TN 38018
(901) 624-0371
(901) 624-0375
Mailing address
8316 MACON TERRACE, SUITE 102, CORDOVA, TN 38018
(901) 624-0371
(901) 624-0375
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H445092
TENNCARE BUREAU-MEDICAID WAIVER
TN
Enumeration date
06/25/2008
Last updated
06/29/2022
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