| NPI | 1053887729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN GAY GAUZE Pres. 606-638-1029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 261QH0700X Clinic/Center Hearing and Speech | |
| 261QP2000X Clinic/Center Physical Therapy | |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2018-10-19 |