| NPI | 1588338032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF BEATY Chief Administrative Officer 502-381-9053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2021-08-06 |