| NPI | 1952846933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK FOGARTY Director 502-744-6664 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 1299) |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2016-12-29 |