| NPI | 1700541646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS LOUIS HALL Owner 502-229-4017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| 2083A0300X Preventive Medicine Addiction Medicine | |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2022-12-07 |