| NPI | 1508917642 |
|---|---|
| Doing Business As | SUPPORTED LIVING - KINGSPORT |
| Entity Type | Organization |
| Authorized Contact | TERESA M KIDD President And CEO 423-467-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TN L 3(20)24M3-076-1414) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2018-10-05 |