| NPI | 1053694463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE ELAINE GOODSELL CEO 270-900-1458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |