| NPI | 1952030645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID ELAM President 606-207-6617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2022-11-03 |