| NPI | 1194254219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON CALES Owner 502-492-7455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2024-10-08 |