Minnola Residential Care Services,LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

1000000018260 Issued in TN

Legal business name

MINNOLA RESIDENTIAL CARE SERVICES,LLC

Practice address

4264 Genyth Ave
Memphis, TN 38128-3212

Phone

(901) 857-6635

NPI assigned

Jun 23, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Terethra Harris

Title

Owner/Director

Phone

(901) 857-6635

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1417308172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4264 GENYTH AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381283212",
            "telephone_number": "901-857-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4264 GENYTH AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381283212",
            "telephone_number": "901-857-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNOLA RESIDENTIAL CARE SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "TERETHRA",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "901-857-6635",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "TN",
            "license": "1000000018260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q021859",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rikki Minkler
• Patriece D Minner, B.S., M.P.A.
• Timothy Dean Minniear, M.D.
• Minnies Haven of Hope Adult Care LLC
• Reginald Eugene Minnis, PTA
• Alyse Soileau Minton, MD
• Philip G Mintz, MD
• Miracle Care Inc
• Sharan Mirchandani, MD
• Andrew Mire, MD

• Nursing Care Agency in Memphis, TN
• Providers in Memphis, TN by specialty
• Nursing Care Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.