| NPI | 1922691930 |
|---|---|
| Former Legal Business Name | MACK MENTAL HEALTH GROUP |
| Entity Type | Organization |
| Authorized Contact | GEORGE MACK Owner/Clinician 423-258-2161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2021-06-08 |