| NPI | 1578020210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM J DIXON CEO 606-548-8937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2024-06-06 |