Provider Demographics
NPI:1013662162
Name:SENSATIONAL ARTISTIC DESIGNS LLC
Entity Type:Organization
Organization Name:SENSATIONAL ARTISTIC DESIGNS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MABONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-648-9354
Mailing Address - Street 1:5810 SHELBY OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7315
Mailing Address - Country:US
Mailing Address - Phone:901-648-9354
Mailing Address - Fax:
Practice Address - Street 1:5810 SHELBY OAKS DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-7315
Practice Address - Country:US
Practice Address - Phone:901-648-9354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency