| NPI | 1154699312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA JEANINE STORY Administrator 731-439-6530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2011-12-02 |