| NPI | 1700279080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ANN GRAY Business Manager 901-757-7979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: TN 14387) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TN 14387) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: TN 14387) | |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-03-11 |