| NPI | 1306583497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE TARPLEY Billing Admin 270-986-7044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2022-06-17 |