NPIMap

Organization Active NPI

Customized Medical Needs

  • Substance Abuse Rehabilitation Facility
  • Memphis, TN
National Provider Identifier
1124361688
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
CUSTOMIZED MEDICAL NEEDS
Practice address
578 Harrell St
Memphis, TN 38112-2932
Phone
(901) 907-0640
Fax
(901) 255-0758
NPI assigned
Apr 3, 2013
Last updated
Sep 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Christi Alexander DavidsonNPI 1063237113
Title
Executive Director
Phone
(866) 563-7772

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 305 TN
Social Worker 104100000X NU
Registered Dietitian 133V00000X NU
Registered Nurse 163W00000X NU
Occupational Therapy Assistant 224Z00000X NU
Physical Therapist 225100000X NU
Physical Therapy Assistant 225200000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Mental Illness Community Based Residential Treatment Facility 320800000X NU
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

578 Harrell St
Memphis, TN 38112-2932

Mailing address

578 Harrell St
Memphis, TN 38112-2932
Phone (901) 907-0640

Other identifiers 2

IdentifierTypeStateIssuer
103G700897OtherTNMEDICARE (PTAN)
1531379MedicaidTN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1124361688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 HARRELL ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122932",
            "telephone_number": "901-907-0640",
            "fax_number": "901-255-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 HARRELL ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122932",
            "telephone_number": "901-907-0640",
            "fax_number": "901-255-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOMIZED MEDICAL NEEDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-03",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "CHRISTI",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "866-563-7772",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "305",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (PTAN)",
            "identifier": "103G700897",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1531379",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.