| NPI | 1073366720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANIE HIRAMOTO Owner 502-547-6686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2024-04-10 |