| NPI | 1992302384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARISSA JANAY MARSHALL CEO 423-316-0557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |