| NPI | 1164787958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL VIBBERT Executive Director 502-749-3257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KY 251S00000X) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2012-07-09 |