| NPI | 1861790131 |
|---|---|
| Other Name | FORTWOOD CENTER |
| Entity Type | Organization |
| Authorized Contact | H. EARL MEDLEY President/CEO 423-266-6751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-10 |