| 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) |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2025-07-09 |