| NPI | 1184813578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM MOORE Chief Financial Officer 270-825-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2007-12-04 |