| NPI | 1295287118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTOIN HANA Owner 606-349-7475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: KY 800225) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2021-10-22 |