| NPI | 1053800110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA KELLEY-FREEMAN, M.S., LCADC, LGPC, CEO 800-867-2395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| 1041C0700X Social Worker Clinical | |
| 163WA0400X Registered Nurse Addiction (Substance Use Disorder) | |
| 163WH0200X Registered Nurse Home Health | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| 207QA0401X Family Medicine Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry | |
| 261QR1300X Clinic/Center Rural Health | |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2018-05-04 |