| NPI | 1639429731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE DURHAM Managing Member 859-605-6390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| Enumeration Date | 2012-09-16 |
| Last Update Date | 2012-09-16 |