| NPI | 1043950322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY MONTGOMERY Managing Partner 859-229-4647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-01 |