| NPI | 1083491138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BERGHAUSEN Owner 502-558-0916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2023-09-20 |