| NPI | 1962242602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY MILLER Owner 859-992-7429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-05-30 |
| Last Update Date | 2025-11-02 |