| NPI | 1164417465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA WOODRUFF Director 423-493-1867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: TN SO/CO286) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2020-08-22 |