| NPI | 1790836831 |
|---|---|
| Doing Business As | PARK PLACE RESIDENTIAL SERVICE |
| Entity Type | Organization |
| Authorized Contact | E DOUGLAS VARNEY President And CEO 423-467-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 315-01-001) |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: VA 315-01-001) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |