| NPI | 1801420450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY A KISER Administrator 606-478-2777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-02-22 |
| Last Update Date | 2020-02-26 |