| NPI | 1184817033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS GONZALES CEO 901-624-2454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2007-08-23 |