| NPI | 1821337866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LYNNIASE MCGOUGHY Manager 731-506-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: TN 3104a0625x) |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2013-02-12 |