| NPI | 1912603101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI M WATSON Clinical Director 502-827-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2023-01-31 |