| NPI | 1144849613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN DAVENPORT Owner 859-620-2526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 164W00000X Licensed Practical Nurse | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 171M00000X Case Manager/Care Coordinator | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2026-06-04 |