| NPI | 1508278458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM R BECK Billing/Contracting Manager 270-777-9283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2015-11-18 |