| NPI | 1235703596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE JUDE SHEEHY Owner 606-390-2262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2026-05-06 |