| NPI | 1003401266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN LEANN MILLER Billing Specialist 270-299-5516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2021-03-09 |