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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) 503-1505
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) 503-1505
(901) 937-4887

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
09/02/2016
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