| NPI | 1780423848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA GIVENS Owner 502-644-4101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-09-10 |