| NPI | 1104603836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH BASS Co Owner 502-671-9908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2023-09-14 |