| NPI | 1023813896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY BEATY VP 502-381-9053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |