| NPI | 1104539311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE ALDRIDGE Program Manager 502-365-7054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 174200000X |
| 177F00000X Lodging | |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2023-01-03 |