| NPI | 1093255440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY BALLARD Member 502-510-9777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2017-03-05 |
| Last Update Date | 2024-04-12 |