| NPI | 1104383488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE WERTS Owner 502-618-2823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2019-02-22 |