| NPI | 1982615043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL BOND CFO 606-329-8588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2021-12-02 |