| NPI | 1023509106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA HART Owner 502-545-1016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: KY 239932) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: KY 165090) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2024-03-08 |