| NPI | 1205267671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIUS DEPP KING Owner/ Executive Director 270-303-4669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: KY K12245600) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 171431) |
| 251B00000X Case Management (Licence: KY 7100347620) | |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2017-03-03 |