Organization · NPI-2

Customized Medical Needs

Substance Abuse Rehabilitation Facility · Memphis, TN

NPI number1124361688

StatusActive

Last updated in NPPESSep 29, 2025

Details

NPI: 1124361688
Entity type: Organization (NPI-2)
Legal business name: Customized Medical Needs
Organization subpart: No
Enumeration date: Apr 3, 2013
Certification date: Sep 29, 2025
Last updated: Sep 29, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
324500000X	Substance Abuse Rehabilitation Facility	–	–	Yes
235Z00000X	Speech-Language Pathologist,	–	–
101YP2500X	Counselor, Professional	305	TN
133V00000X	Dietitian, Registered	–	–
261QR0405X	Clinic/Center, Rehabilitation, Substance Use Disorder	–	–
224Z00000X	Occupational Therapy Assistant	–	–
225100000X	Physical Therapist	–	–
225200000X	Physical Therapy Assistant	–	–
163W00000X	Registered Nurse	–	–
104100000X	Social Worker	–	–
225X00000X	Occupational Therapist	–	–
320800000X	Community Based Residential Treatment Facility, Mental Illness	–	–
261QM0801X	Clinic/Center, Mental Health (Including Community Mental Health Center)	–	–

Practice location

578 Harrell St
Memphis, TN 38112-2932

Phone 901-907-0640 · Fax 901-255-0758

Mailing address

578 Harrell St
Memphis, TN 38112-2932

Phone 901-907-0640 · Fax 901-255-0758

Authorized official

Christi Alexander Davidson
Executive Director
8665637772

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.