| NPI | 1710854062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY FIELDS Director 606-202-3424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2025-10-21 |
| Last Update Date | 2025-10-21 |