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Organization

GROUP INITIATIVES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DARIN LEWIS DANTZLER M.S. (DIRECTOR/THERAPIST)
(901) 746-9592
Entity
Organization

Contact information

Practice address
3155 HICKORY HILL RD, MEMPHIS, TN 38115-2555
(901) 746-9592
(901) 746-9593
Mailing address
3155 HICKORY HILL RD, MEMPHIS, TN 38115-2555
(901) 746-9592
(901) 746-9593

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
LCD0000001036
TN
251S00000X
Community/Behavioral Health Agency
Primary
LCD0000001036
TN

Other

Enumeration date
03/21/2009
Last updated
03/21/2009
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