| NPI | 1528909371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELINE DAVIS Executive Director/Clinician 502-500-9176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2026-04-04 |
| Last Update Date | 2026-04-04 |