Organization Active NPI

Mallory'S Home for the Aged

  • Mental Illness Community Based Residential Treatment Facility
  • Memphis, TN
National Provider Identifier
1356675433
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
MALLORY'S HOME FOR THE AGED
Practice address
207 West Person Ave
Memphis, TN 38128-4637
Phone
(901) 503-1505
Fax
(901) 937-4887
NPI assigned
Sep 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Authorized official

Name
Ms. Lacrecia Lashun McGhee
Title
Owner
Phone
(901) 602-0606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

207 West Person Ave
Memphis, TN 38128-4637

Mailing address

3123 Overbrook Dr
Memphis, TN 38128-4637
Phone (901) 602-0606

Other identifiers 1

IdentifierTypeStateIssuer
H445602MedicaidTN

Other names 1

  • mallory's home for the aged Other name

National Provider Directory

National Provider Directory

Locations

207 W Person Ave
Memphis, TN 38109
Phone (901) 503-1505

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1356675433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 OVERBROOK DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381284637",
            "telephone_number": "901-602-0606",
            "fax_number": "901-773-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 WEST PERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381284637",
            "telephone_number": "901-503-1505",
            "fax_number": "901-937-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLORY'S HOME FOR THE AGED",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-23",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "MCGHEE",
        "authorized_official_first_name": "LACRECIA",
        "authorized_official_middle_name": "LASHUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-602-0606",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H445602",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "mallory's home for the aged",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 22, 2026; 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.