| NPI | 1124872601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARVEL HARRIS Clinical Director 270-313-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2024-10-31 |