| NPI | 1669241873 |
|---|---|
| Doing Business As | MINDBODYSOUL IOP/OP |
| Doing Business As | CHASE M DAUB CENTER |
| Doing Business As | THE SURRENDER PROGRAM |
| Entity Type | Organization |
| Authorized Contact | JOHNATHAN LUCAS BENNETT President & Executive Director 502-749-6344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 177F00000X Lodging | |
| Enumeration Date | 2023-12-28 |
| Last Update Date | 2026-01-15 |