| NPI | 1417360751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRECIA E EATON Managing Member 865-399-2681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 39250) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN 39250) |
| 363A00000X Physician Assistant (Licence: TN 1137) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-05 |