| NPI | 1134019243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN B PHILLIPS Owner 606-595-3218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 251B00000X Case Management | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2026-05-10 |