| NPI | 1194495002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE BARKER Owner 606-548-1728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2023-07-11 |