Providence Home and Community Living Service

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROVIDENCE HOME AND COMMUNITY LIVING SERVICE

Practice address

907 Inman Rd
Memphis, TN 38111-3009

Phone

(901) 791-6041

NPI assigned

Apr 29, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Jasmine Dennis

Title

Administrator

Phone

(901) 791-6041

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1124601000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 INMAN RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381113009",
            "telephone_number": "901-791-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 INMAN RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381113009",
            "telephone_number": "901-791-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HOME AND COMMUNITY LIVING SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "901-791-6041",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dana Lee Prude, RN
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• Community/Behavioral Health Agency in Memphis, TN
• Providers in Memphis, TN by specialty
• Community/Behavioral Health Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.