| NPI | 1700928876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA JACKSON Chief Executive Officer 423-472-5268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TN LPC0000000617) |
| 103K00000X Behavior Analyst | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN 20193) | |
| 225X00000X Occupational Therapist (Licence: TN OT2755) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 363A00000X Physician Assistant (Licence: TN 1509) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2017-10-05 |