| NPI | 1184150229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROSS MANNING COO 423-282-3379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2026-02-24 |