| NPI | 1144959313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BRYAN CONRAD Manager 859-916-2486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-05 |
| Last Update Date | 2022-06-05 |