OrganizationActive
Outstanding Support Services of Tn
NPI 1770161226 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Memphis, TN
Provider details
- NPI number
- 1770161226
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Angelique Dilworth, Chief Executive Officer(901) 453-8838
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Agencies
- Attendant Care Provider3747A0650X
Nursing Service Related Providers
Practice location
3905 Wildleaf Dr
Memphis, TN 38116-5516
Phone: (901) 453-8838
Approximate (ZIP-level) locationGet directions
Mailing address
3905 Wildleaf Dr
Memphis, TN 38116-5516
Registry dates
- Enumerated
- 2021-03-29
- Last updated
- 2026-02-05
- Certified
- 2026-02-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.