| NPI | 1669694220 |
|---|---|
| Doing Business As | HOLSTON RESIDENCE |
| Entity Type | Organization |
| Authorized Contact | TERESA M KIDD President And CEO 423-467-3600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TN L 324-076-1419) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2018-09-24 |