| NPI | 1992162465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANASTASIA JANDES CEO 859-388-0491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 207R00000X Internal Medicine | |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2020-12-18 |