| NPI | 1417717141 |
|---|---|
| Other Name | THE BODY VAULT LLC |
| Entity Type | Organization |
| Authorized Contact | MIAUNA KINNARD Case Manager/Program Coordinator 502-712-7443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-03-20 |