| NPI | 1619773272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE SULLIVAN Administrator/Owner 423-667-7963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-02-24 |