Provider Demographics
NPI:1144254301
Name:MERIDIAN HUMAN SERVICES, INC
Entity type:Organization
Organization Name:MERIDIAN HUMAN SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JO ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MC GHEE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LMSW
Authorized Official - Phone:901-323-8803
Mailing Address - Street 1:2400 POPLAR AVE
Mailing Address - Street 2:STE 211
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-3213
Mailing Address - Country:US
Mailing Address - Phone:901-323-8803
Mailing Address - Fax:
Practice Address - Street 1:2400 POPLAR AVE
Practice Address - Street 2:STE 211
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-3213
Practice Address - Country:US
Practice Address - Phone:901-323-8803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3730807Medicare ID - Type Unspecified