NPI | 1164086013 |
---|---|
Entity Type | Organization |
Authorized Contact | LARISA YASHCHENKO Authorized Representative 502-509-6679 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2019-04-25 |
Last Update Date | 2019-04-25 |