| NPI | 1013450964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA MCLEOD Support Coordinator 423-400-0107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2016-11-27 |
| Last Update Date | 2016-11-27 |