| NPI | 1033407143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL LEGENA MAY Counselor 606-789-4779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2011-07-12 |