| NPI | 1912778069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CARTER Credentialing Manager 859-737-0904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2024-01-09 |