| NPI | 1568625218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH SHELTON Owner 270-442-0834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: KY 1477) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-07-02 |