Organization
CHANGING MINDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA BROOKS BACHELORS OF SW (CEO)
(901) 281-3425
Entity
Organization
Contact information
Practice address
2333 CLIFFDALE CV, MEMPHIS, TN 38127-3514
(901) 281-3425
Mailing address
5417 EAGLE BEAD CV, MEMPHIS, TN 38125-4305
(901) 281-3425
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
05/16/2022
Last updated
05/16/2022
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