| NPI | 1578263554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY SPICE Clinical Director 502-209-8025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2023-03-07 |
| Last Update Date | 2023-03-22 |