| NPI | 1205971421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PIERRE WOMBLE Director 615-391-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TN I 324-106-9406) |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: TN I 324-106-9406) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |