| NPI | 1063886133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMON COBBLE Owner 502-403-5921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: KY MFTMFT00218984) |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2015-11-30 |