| NPI | 1467723486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE D LONG Owner 901-440-6045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TN APN14184) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: TN APN14184) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2021-03-11 |