| NPI | 1972212603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO ROSS CEO 865-712-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2022-11-21 |