| NPI | 1053476333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTI LYNN BLALOCK Director Of Contracting/Reg. Comp. 423-467-3741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: TN 430) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2025-10-13 |