| NPI | 1245998467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY SAGE BELKNAP-GREENE Member 859-200-9858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-12-05 |
| Last Update Date | 2022-04-10 |