Provider Demographics
NPI:1033975149
Name:ENLIGHTENMENT TRANSITIONAL LIVING LLC
Entity type:Organization
Organization Name:ENLIGHTENMENT TRANSITIONAL LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERAKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-857-1193
Mailing Address - Street 1:8295 TOURNAMENT DR STE 150
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-8900
Mailing Address - Country:US
Mailing Address - Phone:901-356-8075
Mailing Address - Fax:
Practice Address - Street 1:8295 TOURNAMENT DR STE 150
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-8900
Practice Address - Country:US
Practice Address - Phone:901-356-8075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, ChildGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No372600000XNursing Service Related ProvidersAdult Companion
No251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management