| NPI | 1235714932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS KOBLER Owner 865-805-2527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-14 |
| Last Update Date | 2021-05-27 |