| NPI | 1649712100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD PEGUES Owner 901-240-9601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |