| NPI | 1548757677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY A HENEGAR Crenditaling Specialist 423-341-2570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Enumeration Date | 2018-04-14 |
| Last Update Date | 2018-04-14 |