| NPI | 1255162780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL JOHNSON CEO/Owner 901-428-5865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-08-07 |