| NPI | 1265737795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN CLARK Administrator 901-314-0146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TN I000000007899) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |