Organization · NPI-2

Advanced Horizons LLC

Clinic/Center, Adult Mental Health · Memphis, TN

NPI number1417027327
StatusActive
Last updated in NPPESAug 21, 2007

Details

NPI
1417027327
Entity type
Organization (NPI-2)
Legal business name
Advanced Horizons LLC
Organization subpart
No
Enumeration date
Nov 8, 2006
Last updated
Aug 21, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental HealthI 215-096-9686TNYes

Practice location

6685 Quince Rd
Suite 124
Memphis, TN 38119-8038

Phone 901-624-3581 · Fax 901-757-3830

Mailing address

6685 Quince Rd
Suite 124
Memphis, TN 38119-8038

Phone 901-624-3581 · Fax 901-757-3830

Authorized official

Stan Caummisar
Cheif Manager
9016243581

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