| NPI | 1003948985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LEANN SPARKS Program Specialist 859-744-4482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center Public Health, State or Local |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |