| NPI | 1750100384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS MULLINS Administrator 606-784-1142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-10-09 |
| Last Update Date | 2024-11-11 |