Organization
YOUTH VILLAGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIE DANIELS (CLINICAL SUPERVISOR)
(901) 252-7643
Entity
Organization
Contact information
Practice address
5515 SHELBY OAKS DR, MEMPHIS, TN 38134-7316
(901) 252-7938
Mailing address
1876 W FLETCHER RUN CIR, APT 202, CORDOVA, TN 38016-2021
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/15/2007
Last updated
08/22/2020
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