Organization
SOUL HOSPITAL WITH DR. CHAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLOTTE ANN FRYE LMHC, LPC-MHSP (PRESIDENT)
(865) 806-4403
Entity
Organization
Contact information
Practice address
1416 BREDA DR, KNOXVILLE, TN 37918-1401
(865) 806-4403
Mailing address
1416 BREDA DR, PO BOX 5450, KNOXVILLE, TN 37918-1401
(865) 806-4403
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3163
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002043100
—
FL
Enumeration date
03/25/2015
Last updated
03/25/2015
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