| NPI | 1871361436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAY EUGENE STALCUP Co Owner 865-406-2715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-12-13 |
| Last Update Date | 2024-01-23 |