| NPI | 1083423875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE RAE KEATS Chief Operating Officer 502-322-7622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-08-12 |