| NPI | 1598042962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM NUNNIKHOVEN Board Chair 901-833-9744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TN L000000009711) |
| Enumeration Date | 2011-11-13 |
| Last Update Date | 2011-11-13 |