| NPI | 1063930824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEANDRIA F EVANS Chief Executive Officer 901-808-5172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2017-09-22 |