| NPI | 1891353504 |
|---|---|
| Doing Business As | 897 MOUNT RUSHMORE DRIVE |
| Entity Type | Organization |
| Authorized Contact | STACY LYNN HARRIS Owner/Manager 606-776-4741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2022-02-15 |