Active NPI
Mallory'S Home for the Aged
- Mental Illness Community Based Residential Treatment Facility
- Memphis, TN
National Provider Identifier
1356675433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H445602 | Medicaid | TN |
Other names 1
- mallory's home for the aged
National Provider Directory
National Provider DirectoryLocations
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.