Organization
GOODWILLHOMESCOMMUNITYSERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN M. MILLS (CHIEF EXECUTIVEOFFICER)
(901) 785-6790
Entity
Organization
Contact information
Practice address
4590 GOODWILL RD, MEMPHIS, TN 38109-5714
(901) 785-6790
(901) 789-8351
Mailing address
PO BOX 161282, MEMPHIS, TN 38186-1282
(901) 785-6790
(901) 789-8351
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
SO/10802A
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1450144
—
TN
Enumeration date
06/30/2011
Last updated
06/30/2011
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