| NPI | 1376906073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL EARL WESLEY Owner 901-864-1630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |