| NPI | 1124235544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY A PANK Paralegal 502-420-2666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2016-06-16 |