| NPI | 1649537002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. MICHAEL MOUNTAIN CFO 270-689-6649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2012-04-23 |