| Jaded Lotus Aba Llc | |
|
3834 Ginkgo Ln Apt 206 Memphis TN 38125-6538 | |
| (901) 336-4225 | |
| Not Available |
| Full Name | Jaded Lotus Aba Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3834 Ginkgo Ln Apt 206, Memphis, Tennessee |
| Authorized Official Name and Position | Jojuan Fullwiley (BCBA) |
| Authorized Official Contact | 9014980108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaded Lotus Aba Llc 3834 Ginkgo Ln Apt 206 Memphis TN 38125-6538 Ph: (901) 336-4225 | Jaded Lotus Aba Llc 3834 Ginkgo Ln Apt 206 Memphis TN 38125-6538 Ph: (901) 336-4225 |
| NPI Number | 1023644366 |
|---|---|
| Provider Enumeration Date | 03/18/2020 |
| Last Update Date | 07/11/2023 |
| Certification Date | 07/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023644366 | NPI | - | NPPES |
| 14404249 | Other | CAQH | |
| Q047274 | Medicaid | TN | |
| Q0565582 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
News Archive
"In this year's farm bill, there is a crucial opportunity to reform how the United States handles international food aid programs," GROW campaign manager Vicky Rateau writes in this post in Oxfam's "The Politics of Poverty" blog.
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