| NPI | 1043946783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKKLE HAMPTON CEO 606-341-1160 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2022-07-26 |