| NPI | 1164661849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA LYNN TURNER CEO 502-489-5233 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: KY 203111) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-02-19 |