OrganizationActive
My Holistic Life, LLC
NPI 1366051823 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Collierville, TN
Provider details
- NPI number
- 1366051823
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Ronda Welty, Owner
Practice location
10454 Juneau Way
Collierville, TN 38017-1968
Phone: (901) 568-0442
Fax: (901) 284-0008
Mailing address
10454 Juneau Way
Collierville, TN 38017-1968
Registry dates
- Enumerated
- 2020-07-30
- Last updated
- 2020-07-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.