Organization
LIFE ENHANCEMENT SERVICES - TENNESSEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK YATES (CEO)
(901) 336-8414
Entity
Organization
Contact information
Practice address
1180 MINNA PL, MEMPHIS, TN 38104-4607
(901) 336-8414
(901) 328-1402
Mailing address
1180 MINNA PL, MEMPHIS, TN 38104-4607
(901) 336-8414
(901) 328-1402
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1513052
—
TN
Enumeration date
05/22/2009
Last updated
12/11/2013
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