| NPI | 1619014495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN MICHAEL ALLEN Director 615-230-4922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TN L3(20)4M5-026-3249) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |