| NPI | 1902942485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEXIE E WHITE Executive Director 423-296-4224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 251S00000X Community/Behavioral Health | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 133V00000X Dietitian, Registered | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2009-05-28 |