| NPI | 1730892837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASITY J TANKERSLEY Office Manager 931-841-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2023-09-28 |