Organization
SUPPORT SOLUTIONS OF TENNESSEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANGELIQUE VATOCO DILWORTH MA (BEHAVIOR ANALYST)
(901) 383-9193
Entity
Organization
Contact information
Practice address
5909 SHELBY OAKS DR STE 100, MEMPHIS, TN 38134-7318
(901) 383-9193
(901) 383-9195
Mailing address
5909 SHELBY OAKS DR STE 100, MEMPHIS, TN 38134-7318
(901) 383-9193
(901) 383-9195
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
PSS0000000274
TN
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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