| NPI | 1942666151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRY BOLTON PRATT President 731-513-1130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TN MD 19615) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TN LPC 0813) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: TN P1021) | |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |