| NPI | 1083982185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: KY ADCLAD00225185) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: KY KY-0001) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2016-04-13 |