| NPI | 1568889509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA OWEN Executive Director 270-926-7813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 385H00000X Respite Care | |
| 101YP2500X Counselor, Professional | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2021-06-24 |