| NPI | 1285946301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY BRADFORD Co Owner/Partnership 901-268-7531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: TN L000000005891) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: TN L000000005891) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2010-07-06 |