West Tennessee Regional Office

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

OT1340 Issued in TN

Legal business name

WEST TENNESSEE REGIONAL OFFICE

Practice address

11293 Memphis Arlington Rd
Arlington, TN 38002-7978

Phone

(901) 745-7573

Fax

(901) 745-7468

NPI assigned

May 12, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Anjali Vasishta, OTR/L

Title

Occupational Therapist

Phone

(901) 745-7573

Specialties & licenses 1

Addresses

Other names 1

• Divison for Development and Intellectual Disabilities Doing business as

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1629360375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 949",
            "address_2": "11293 MEMPHIS ARLINGTON RD",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "38002",
            "telephone_number": "901-745-7573",
            "fax_number": "901-745-7468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11293 MEMPHIS ARLINGTON RD",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380027978",
            "telephone_number": "901-745-7573",
            "fax_number": "901-745-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TENNESSEE REGIONAL OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "VASISHTA",
        "authorized_official_first_name": "ANJALI",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "901-745-7573",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TN",
            "license": "OT1340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divison for Development and Intellectual Disabilities",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.