| NPI | 1427329804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL HUGHES MELTON Director 276-395-3938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-06-24 |