| NPI | 1144039652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHELSEA BROWN Credentialing Agent 859-270-8099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-12-31 |
| Last Update Date | 2024-12-31 |