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 |