| NPI | 1215274873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BURNS JACKSON Owner 615-668-3917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TN I0000000010203) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |