| NPI | 1346723178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DEATON Owner 502-803-7445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2025-04-03 |