| NPI | 1508327198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORNELIUS MARTIN MCKEE Administrator 423-244-5468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2019-03-27 |