| NPI | 1053638650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILFRED LEE JONES Owner/Operator 270-554-9216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 810275) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2010-04-23 |