| NPI | 1134439557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN D FERGUSON Program Adminstrator 606-789-4779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KY 810272) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |