| NPI | 1831573732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MICHAEL THAYER Clinical Director 606-679-6995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 06202015) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-07-10 |