| NPI | 1225576044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVANIE SMITH Program Director 859-492-8509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 171070) |
| 101YP2500X Counselor, Professional (Licence: KY 164125) | |
| 171M00000X Case Manager/Care Coordinator | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: KY 46380) | |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-04-06 |