| NPI | 1891131801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN DAVIS Facility Director, Staff Nurse 731-549-7290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: TN ACL0000000369) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2013-05-16 |