| NPI | 1720468937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA K CLARK Owner 606-886-9989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 810154) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2015-06-04 |