| NPI | 1528405925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY CANTRELL Credentialing 423-443-3336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: TN 31714) |
| Enumeration Date | 2013-05-27 |
| Last Update Date | 2023-02-07 |