| NPI | 1417409962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY LINVILLE Owner 731-412-4179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TN I000000018190) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2016-11-01 |