| NPI | 1679389332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTWONE SHAW CEO 502-322-2065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2024-12-10 |