| NPI | 1538622899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA FORD Co Owner 812-583-7947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QR0800X Clinic/Center, Recovery Care | |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2019-04-12 |