| NPI | 1437949849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA STUMBO Clinic Supervisor/Executive Directo 606-359-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-08 |