| NPI | 1033567268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA DECKERT Director Of Contracting 615-519-4156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL 59359) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2021-01-12 |