| NPI | 1689077802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID LEMAI JACKSON Owner 615-484-1642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2014-10-01 |