| NPI | 1093186538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY LLOYD LUCAS Market Manager/ Operations Director 270-781-3387 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: KY 810200) |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: KY 810200) |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2020-09-25 |