| NPI | 1629282470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PHILLIP FARLEY VP & Secretary 615-716-9335 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: WI 1748) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1748) |
| 261QM0801X | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2024-04-12 |