Organization
MALLORY'S HOME FOR THE AGED
Active
Other names
mallory's home for the aged
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LACRECIA LASHUN MCGHEE (OWNER)
(901) 602-0606
Entity
Organization
Contact information
Practice address
207 WEST PERSON AVE, MEMPHIS, TN 38128-4637
(901) 503-1505
(901) 937-4887
Mailing address
3123 OVERBROOK DR, MEMPHIS, TN 38128-4637
(901) 602-0606
(901) 773-8580
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H445602
—
TN
Enumeration date
09/23/2009
Last updated
07/22/2026
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