Organization
REJUVENESCENSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANORA OWENS (DIRECTOR)
(901) 930-6966
Entity
Organization
Contact information
Practice address
10357 IVY LAUREL CV, CORDOVA, TN 38018-6685
(901) 930-6966
Mailing address
10357 IVY LAUREL CV, CORDOVA, TN 38018-6685
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
04/01/2022
Last updated
04/01/2022
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