| NPI | 1720842958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS N CROOK Co Owner 502-322-7071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X | |
| Enumeration Date | 2024-02-08 |
| Last Update Date | 2024-02-08 |