Organization
MID-SOUTH HEALTHNET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARLIN ANGELL (CHIEF EXECUTIVE OFFICER)
(901) 383-9193
Entity
Organization
Contact information
Practice address
5909 SHELBY OAKS DRIVE SUITE 100, MEMPHIS, TN 38134
(901) 383-9193
(901) 383-9195
Mailing address
5909 SHELBY OAKS DRIVE SUITE 100, MEMPHIS, TN 38134
(901) 383-9193
(901) 383-9195
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q013314
—
TN
Enumeration date
06/11/2015
Last updated
06/15/2015
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