| NPI | 1427719764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BERGHAUSEN Np/Owner 502-558-0916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-01-09 |
| Last Update Date | 2023-07-24 |