| NPI | 1154093037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVEN MARSHALL Owner 901-859-9830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2021-10-09 |