MALLORY'S HOME FOR THE AGED NPI 1356675433

NPI Information

  • NPI: 1356675433
  • Provider Name: MALLORY'S HOME FOR THE AGED
  • Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
  • Entity Type: Organization
  • Other Name: MALLORY'S HOME FOR THE AGED
  • Address: 207 WEST PERSON AVE
    MEMPHIS, TN
    ZIP 38128
  • Phone: (901) 503-1505

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NPI Details

MALLORY'S HOME FOR THE AGED is a community based residential treatment facility mental illness in Memphis, TN. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. MALLORY'S HOME FOR THE AGED NPI is 1356675433. The provider is registered as an organization entity type.
The provider Other Name Is Mallory's Home For The Aged.

The provider's business location address is:

207 WEST PERSON AVE
MEMPHIS, TN
ZIP 38128-637
Phone: (901) 503-1505
Fax: (901) 937-4887

The provider's authorized official is Lacrecia Lashun Mcghee .
The authorized official title is Owner and has the following contact phone number (901) 503-1505.

The enumeration date for this NPI number is 9/23/2009 and was last updated on 9/2/2016.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H445602MEDICAIDTENNESSEE

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: 11/21/2025

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