| NPI | 1215890165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON FORD CEO 859-300-9760 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-12-08 |
| Last Update Date | 2025-12-08 |