| NPI | 1528897451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE L DODGE Owner 931-952-3499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2024-07-30 |
| Last Update Date | 2024-07-31 |