| NPI | 1639956527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY COLLIER COO 606-471-4546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-09-13 |
| Last Update Date | 2023-11-28 |