| NPI | 1114509759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL WEBB Owner/Provider 606-637-2256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2021-04-23 |