| NPI | 1972973097 |
|---|---|
| Doing Business As | 1806 PENNINGTON |
| Entity Type | Organization |
| Authorized Contact | WAYNE ADDISON COO 901-692-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TN L000000012141) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2015-10-01 |