| NPI | 1356022693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAUFIK KASSIS Owner 606-663-7597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker Clinical | |
| 207QA0401X Family Medicine Addiction Medicine | |
| 207RA0401X Internal Medicine Addiction Medicine | |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2023-08-18 |