| NPI | 1033080387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR RICARDO RICE Executive Director 502-384-9371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-09-17 |
| Last Update Date | 2025-09-17 |