Provider Demographics
NPI:1386442036
Name:H.A.B.I.T.S 360, LLC
Entity type:Organization
Organization Name:H.A.B.I.T.S 360, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:TIJUANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-849-9932
Mailing Address - Street 1:131 S CENTER ST
Mailing Address - Street 2:P.O BOX 285
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017
Mailing Address - Country:US
Mailing Address - Phone:901-849-9932
Mailing Address - Fax:346-205-0454
Practice Address - Street 1:1166 N HOUSTON LEVEE RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7159
Practice Address - Country:US
Practice Address - Phone:901-878-5895
Practice Address - Fax:346-205-0454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center