Organization
BLACK HOLDINGS GROUP,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUDRIA KAYE BLACK MD (PHYSICIAN)
(901) 755-6280
Entity
Organization
Contact information
Practice address
8000 CENTERVIEW PKWY, SUITE 104, CORDOVA, TN 38018-4227
(901) 755-6280
(901) 755-7897
Mailing address
PO BOX 38175, GERMANTOWN, TN 38183-0175
(901) 755-6280
(901) 755-7897
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
36627
TN
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
36627
TN
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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