| NPI | 1740065713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIAMOND CALLOWAY Executive Director 502-656-9261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2024-05-07 |