| NPI | 1124637442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER A WYATT Office Manager 423-405-9084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251B00000X Case Management |
| 261QR1300X Clinic/Center, Rural Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-07-23 |