| NPI | 1184305666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK O ROACH Chief Operations Officer 901-859-2071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2023-07-27 |