| NPI | 1457952012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH NALLEY CEO 502-690-1511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone |
| Additional Taxonomies | 2083A0300X Preventive Medicine Addiction Medicine |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2020-11-02 |