| NPI | 1104959766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL JONES Co Director 270-759-9977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KY 33000118) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2019-12-23 |