Provider Demographics
NPI:1922565514
Name:TTMSCARES
Entity Type:Organization
Organization Name:TTMSCARES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TENEKA
Authorized Official - Middle Name:TERIE
Authorized Official - Last Name:MACON-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-600-0664
Mailing Address - Street 1:2373 MEADOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-8468
Mailing Address - Country:US
Mailing Address - Phone:901-600-0664
Mailing Address - Fax:
Practice Address - Street 1:2373 MEADOW RIDGE DR
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-8468
Practice Address - Country:US
Practice Address - Phone:901-600-0664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty