| NPI | 1386133551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT BALOGH Owner 901-465-5466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TN MD48264) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TN MD48264) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-12-17 |