| NPI | 1750949863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI RAYBURN-DEHART Executive Director 606-465-0786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2023-06-20 |