| NPI | 1548055288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYNN SAMUELS Owner/Co Founder/Manager 502-219-2566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-04-12 |
| Last Update Date | 2025-04-12 |