| NPI | 1356695100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK KENDRICK Program Director 859-887-3712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 207QA0401X Family Medicine, Addiction Medicine | |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2017-08-17 |