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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. FRANK GATTUSO (ADMINISTRATOR)
(901) 386-3211
Entity
Organization

Contact information

Practice address
2805 CHARLES BRYAN RD, MEMPHIS, TN 38134-4756
(901) 386-3211
(901) 405-3783
Mailing address
2805 CHARLES BRYAN RD, MEMPHIS, TN 38134-4756
(901) 386-3211
(901) 405-3783

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
0000000232
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7440499
TN
Enumeration date
12/13/2006
Last updated
02/02/2009
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