| NPI | 1205077294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER E FISHER Owner 502-552-3107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 34003596A) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2009-03-20 |