| NPI | 1922727510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEROY ANAGHO Register Nurse 901-230-6745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2022-08-25 |