Provider Demographics
NPI:1073135059
Name:KNOWLEDGE QUEST
Entity Type:Organization
Organization Name:KNOWLEDGE QUEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST/SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:LABRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:501-837-4526
Mailing Address - Street 1:PO BOX 2119
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38101-2119
Mailing Address - Country:US
Mailing Address - Phone:901-942-1512
Mailing Address - Fax:
Practice Address - Street 1:990 COLLEGE PARK DR STE 104
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38126-6519
Practice Address - Country:US
Practice Address - Phone:901-942-1512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness