| NPI | 1619612231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE SHORT Owner/Authorized Official 606-389-5269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2024-06-03 |