| NPI | 1154205896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONTE MANDELLA PAUL CEO 270-590-2519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2025-08-05 |
| Last Update Date | 2025-08-05 |