Provider Demographics
NPI:1629816913
Name:SHAKTI'S GREENHOUSE LLC
Entity type:Organization
Organization Name:SHAKTI'S GREENHOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHUBI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-277-8713
Mailing Address - Street 1:8336 MACON ROAD
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018
Mailing Address - Country:US
Mailing Address - Phone:901-277-8713
Mailing Address - Fax:901-682-3049
Practice Address - Street 1:8336 MACON ROAD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018
Practice Address - Country:US
Practice Address - Phone:901-277-8713
Practice Address - Fax:901-682-3049
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLUES CITY PSYCHIATRY PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty