| NPI | 1497208524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE C. DAVIS Owner 270-991-2951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: KY 161534) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |