| NPI | 1629784418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY R DUKES CEO & President 270-754-3494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor Professional | |
| 207Q00000X Family Medicine | |
| 207QA0401X Family Medicine Addiction Medicine | |
| 207RA0401X Internal Medicine Addiction Medicine | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2024-02-01 |