| NPI | 1497030928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WADE WATSON Owner/Director Of Operations 270-202-3595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-10-16 |
| Last Update Date | 2023-11-17 |