| NPI | 1174790414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZ IRENE CHANCELLOR Administrator 502-499-5559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |