| NPI | 1114073368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE STILLS Administrator 423-638-9995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: TN 64504) |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2011-03-11 |