| NPI | 1225755259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA LYNN LEWIS Director 606-312-5897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-10-20 |
| Last Update Date | 2023-02-28 |