| NPI | 1528397189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN B CLARK Administrator 901-314-0146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: TN L000000003760) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2009-12-10 |