Provider Demographics
NPI:1598293961
Name:EXPLORATORY CENTERS OF AMERICA, LLC
Entity Type:Organization
Organization Name:EXPLORATORY CENTERS OF AMERICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LULA
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:SANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-254-6853
Mailing Address - Street 1:1959 DARTFORD CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-1411
Mailing Address - Country:US
Mailing Address - Phone:901-907-1041
Mailing Address - Fax:
Practice Address - Street 1:1959 DARTFORD CV
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-1411
Practice Address - Country:US
Practice Address - Phone:901-907-1041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI0000000201423747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty