NPI | 1366051823 |
---|---|
Entity Type | Organization |
Authorized Contact | RONDA MAE WELTY Owner 901-568-0442 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
Additional Taxonomies | 261QD1600X Clinic/Center Developmental Disabilities |
Enumeration Date | 2020-07-30 |
Last Update Date | 2020-07-30 |