| NPI | 1861024424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON CALES Owner 502-492-7455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor Professional | |
| 1041C0700X Social Worker Clinical | |
| 207L00000X Anesthesiology | |
| 207LA0401X Anesthesiology Addiction Medicine | |
| 207LP2900X Anesthesiology Pain Medicine | |
| 207QA0401X Family Medicine Addiction Medicine | |
| 207R00000X Internal Medicine | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2022-08-30 |