| NPI | 1649330523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE COX Director Of Personnel 423-434-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X (Licence: TN L 3(20)4m5-045-720) |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: TN L 3(20)4m5-045-720) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TN L 3(20)4m5-045-720) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |