| NPI | 1053257857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIJAH J CARRADINE Ed 502-526-8256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2026-04-25 |
| Last Update Date | 2026-04-26 |