| NPI | 1093519902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APOLLOS ATWOOD Owner 502-401-3028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-04-01 |
| Last Update Date | 2025-04-01 |