Provider Demographics
NPI:1952745127
Name:TENNESSEE LEARNING ACADEMY
Entity type:Organization
Organization Name:TENNESSEE LEARNING ACADEMY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-273-4336
Mailing Address - Street 1:PO BOX 753553
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38175-3553
Mailing Address - Country:US
Mailing Address - Phone:901-273-4336
Mailing Address - Fax:
Practice Address - Street 1:2491 JOY LN
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38114-6088
Practice Address - Country:US
Practice Address - Phone:901-273-4336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSO/C0349320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness