| NPI | 1144748633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL L ROSS Operations Manager 901-249-2456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2017-09-05 |