| NPI | 1184175325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH CASELDEN Owner 270-228-2991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2021-04-13 |