Provider Demographics
NPI:1790221166
Name:ASSISTED LIVING AND PERSONAL CARE SERVICES
Entity Type:Organization
Organization Name:ASSISTED LIVING AND PERSONAL CARE SERVICES
Other - Org Name:RIVERCITY SUPPORTIVE LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MS.
Authorized Official - Prefix:PROF
Authorized Official - First Name:TAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:901-265-7077
Mailing Address - Street 1:1779 KIRBY PARKWAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138
Mailing Address - Country:US
Mailing Address - Phone:901-265-7077
Mailing Address - Fax:
Practice Address - Street 1:5405 FOX PLAZA DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-1518
Practice Address - Country:US
Practice Address - Phone:901-265-7077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)