| NPI | 1477399046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL MICHELLE SNELL Owner/Provider 865-212-0733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2025-02-22 |