| NPI | 1134674237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY A PANK Paralegal 502-420-2666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2018-09-04 |