| NPI | 1619752607 |
|---|---|
| Doing Business As | SPARC |
| Entity Type | Organization |
| Authorized Contact | MONICA LAWRENCE Credentialing Specialist 502-656-2429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-08-28 |