Provider Demographics
NPI:1952136368
Name:HEAL MEMPHIS
Entity type:Organization
Organization Name:HEAL MEMPHIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:CRISHAUN
Authorized Official - Last Name:OUSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:901-249-4120
Mailing Address - Street 1:3385 AIRWAYS BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-3808
Mailing Address - Country:US
Mailing Address - Phone:901-249-4120
Mailing Address - Fax:901-666-1925
Practice Address - Street 1:3385 AIRWAYS BLVD STE 204
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-3808
Practice Address - Country:US
Practice Address - Phone:901-249-4120
Practice Address - Fax:901-666-1925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty