| NPI | 1215328901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT MOORING VP, Regulatory Affairs & Qi 502-515-0430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |