| NPI | 1659436228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTI LYNN BLALOCK Director Of Contracting/Compliance 423-467-3741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: VA 315-16-001) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: VA 315-07-004) |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: VA 315-07-004) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: VA 315-07-004) | |
| 385H00000X Respite Care (Licence: VA 315-03-001) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2025-03-12 |