| NPI | 1194254219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON CALES Owner 502-492-7455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2024-02-05 |