| NPI | 1124911854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY M MONROY Outreach Coodinator 740-202-2703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2025-06-02 |
| Last Update Date | 2025-06-02 |