| NPI | 1043685563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE LARVEL RICKETTS Residential Counselor 615-460-4290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |