| NPI | 1174387708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVA ARCHIE Program Amin 502-409-4357 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 106H00000X Marriage & Family Therapist | |
| 174400000X Specialist | |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 261QC1500X Clinic/Center Community Health | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2024-02-13 |
| Last Update Date | 2025-07-26 |