| NPI | 1578372686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG FARRELL President 270-842-4428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2025-01-03 |
| Last Update Date | 2025-01-28 |