| NPI | 1639998099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON ERB Manager 859-304-4047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2024-10-04 |