Organization
DAGAMAC ENTERPRISES LLC
Active
Other names
New Horizons Counseling/Broken Wings Pgm
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRYL WADE MCINTOSH CADC, MACA (COUNSELOR/THERAPIST)
(270) 338-2280
Entity
Organization
Contact information
Practice address
441 HOPKINSVILLE ST, GREENVILLE, KY 42345-1101
(270) 338-2280
(270) 338-0795
Mailing address
441 HOPKINSVILLE ST, GREENVILLE, KY 42345-1101
(270) 338-2280
(270) 338-0795
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
KY-0191
KY
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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