| NPI | 1306619499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSCAR D RIVERO AMADOR Owner 865-324-2043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2024-02-12 |