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CUSTOMIZED VETERANS GROUP
NPI 1184435802
Counselor - Addiction (Substance Use Disorder) in Memphis, TN

Active since January 14, 2025
578 HARRELL ST, MEMPHIS, TN 38112(901) 907-0640(901) 255-0758 Get Directions Write a Review

NPPES record last updated: January 14, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Customized Veterans Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CUSTOMIZED VETERANS GROUP (NPI 1184435802) is a healthcare organization registered as an addiction (substance use disorder) in Memphis, Tennessee and active in the NPI registry since January 2025. The organization lists Antwane Bohanon, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1184435802
Entity TypeOrganization
Primary Taxonomy101YA0400X
Legal Business NameCUSTOMIZED VETERANS GROUP
Location Address578 HARRELL STMemphis, TN 38112-2932
Mailing Address578 Harrell StMemphis, TN 38112-2932 · (901) 907-0640 · Fax (901) 255-0758
Phone(901) 907-0640
Fax(901) 255-0758
Organization SubpartNo
Authorized OfficialAntwane BohanonChief Executive Officer · (808) 453-0018
Enumeration DateJanuary 14, 2025
NPPES CertifiedJanuary 14, 2025
✔ NPI 1184435802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
578 HARRELL ST, Memphis, TN 38112
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTI DAVIDSON LIFESTYLE COACH
Health and Wellness Coach
578 HARRELL ST
MEMPHIS, TN 38112
Shelby County (901) 319-8452
CUSTOMIZED MEDICAL NEEDS
Substance Abuse Rehabilitation Facility
578 HARRELL ST
MEMPHIS, TN 38112
Shelby County (901) 907-0640
MR. TERRY HILL LC
Health and Wellness Coach
578 HARRELL ST
MEMPHIS, TN 38112
Shelby County (901) 907-0640

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Customized Veterans Group's NPI number?

The NPI number for Customized Veterans Group is 1184435802. It was assigned to this organization in the NPPES registry on January 14, 2025.

Where is Customized Veterans Group located?

Customized Veterans Group is located at 578 Harrell St, Memphis, TN 38112. The listed phone number is (901) 907-0640.

What is Customized Veterans Group's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Customized Veterans Group was last updated on January 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.