| NPI | 1821762592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA CAUDILL Administrator 606-223-5119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2022-09-27 |