| NPI | 1124784483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISHIA L DURRETT JOHNSON CEO, Clinical Director 502-379-5749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2024-05-06 |