| NPI | 1669241873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNATHAN LUCAS BENNETT President & Executive Director 502-498-7588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-12-28 |
| Last Update Date | 2023-12-28 |