| NPI | 1104469873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS DANIEL MILLER CEO 502-562-4004 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit |
| Additional Taxonomies | 261QR0400X Clinic/Center Rehabilitation |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2020-03-12 |