| NPI | 1467040063 |
|---|---|
| Doing Business As | STAY CLEAN |
| Entity Type | Organization |
| Authorized Contact | EUGENE GILCHRIST CEO 502-681-6964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2021-01-08 |