Organization
THE AGENCY FOR YOUTH AND FAMILY DEVELOPMENT
Active
Parent organization
THE AGENCY FOR YOUTH AND FAMILY DEVELOPMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE AGENCY FOR YOUTH AND FAMILY DEVELOPMENT
Authorized official
DR. GERALD JEROME JORDAN THD (CEO)
(901) 387-5840
Entity
Organization
Contact information
Practice address
1071 MULLINS STATION RD, MEMPHIS, TN 38134-7723
(901) 387-5840
(901) 387-5739
Mailing address
1071 MULLINS STATION RD, MEMPHIS, TN 38134-7723
(901) 387-5840
(901) 387-5739
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
L237M30176449
TN
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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