| NPI | 1255780037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC HICK CFO 270-689-6540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2024-07-02 |