| NPI | 1801018387 |
|---|---|
| Doing Business As | R. GRANT WIDNER GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | TERESA M KIDD President/CEO 423-467-3600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: TN 20647) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TN L 324-076-1424) |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: TN L324-076-1424) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2018-10-05 |