| NPI | 1891390225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY ELISE FLIPPINS Owner 502-338-6124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2021-10-13 |