| NPI | 1811389158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OBIE BEARD Vice President 731-402-1078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: TN 170354228) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: TN 78989) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2022-07-21 |