| NPI | 1871067611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS M MORRISON Owner 270-240-1785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2024-05-16 |