| NPI | 1174687156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN SLATER Administrator 270-651-5246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 810013) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2020-08-22 |