Organization
HUMAN NATURE, LLC
Active
Other names
CrossFit R837
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK MASON LMFT (OWNER, THERAPIST)
(270) 904-4088
Entity
Organization
Contact information
Practice address
1960 LOUISVILLE RD STE A, BOWLING GREEN, KY 42101-1254
(270) 904-4088
Mailing address
668 WINDMILL CIR, BOWLING GREEN, KY 42104-3833
(270) 996-7400
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
106719
KY
Other
Enumeration date
06/15/2017
Last updated
06/15/2017
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