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MINNOLA RESIDENTIAL CARE SERVICESLLC NPI 1417308172


NPI Information

NPI: 1417308172
Provider Name: MINNOLA RESIDENTIAL CARE SERVICES,LLC
Classification: Nursing Care - 251J00000X
Entity Type: Organization
Address:
4264 GENYTH AVE
MEMPHIS, TN
ZIP 38128
Phone: (901) 857-6635
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MINNOLA RESIDENTIAL CARE SERVICES,LLC is a nursing care in Memphis, TN. The provider is a Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. MINNOLA RESIDENTIAL CARE SERVICES,LLC NPI is 1417308172. The provider is registered as an organization entity type.

The provider's business location address is:

4264 GENYTH AVE
MEMPHIS, TN
ZIP 38128-212
Phone: (901) 857-6635

The provider's authorized official is Terethra Harris .
The authorized official title is Owner/director and has the following contact phone number (901) 857-6635.

The enumeration date for this NPI number is 6/23/2016 and was last updated on 6/23/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251J00000XNursing Care1000000018260TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1Q021859MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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