| NPI | 1750033478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY LYN CAMBRON Owner 502-426-6022 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2022-01-24 |