| NPI | 1245746171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUBRON DAVIS Administrator 423-825-5210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: TN 0000000291) |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2017-12-14 |