| NPI | 1790811149 |
|---|---|
| Other Name | FORTWOOD CENTER |
| Entity Type | Organization |
| Authorized Contact | MELISSA QUEEN-PENNINGTON CFO 423-266-6751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: TN L214-076-1367) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2011-10-15 |