| NPI | 1194239269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOIS EDWARDS Operations Officer 270-754-3494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2017-11-27 |