| NPI | 1124733415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVA ARCHIE Clinical Supervisor 502-409-4357 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 172V00000X Community Health Worker | |
| 174H00000X Health Educator | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2023-08-21 |