Organization
WILSHIRE SUPPORTIVE LIVING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALFRED MICHAEL MOORE BSW (DIRECTOR)
(901) 215-4387
Entity
Organization
Contact information
Practice address
937 MAPLE DR, MEMPHIS, TN 38108-3230
(901) 215-4387
Mailing address
4345 OAK CHASE CV, MEMPHIS, TN 38125-2912
(901) 215-4387
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/18/2025
Last updated
02/18/2025
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