| NPI | 1205300969 |
|---|---|
| Other Name | PHOENIX PLACE |
| Entity Type | Organization |
| Authorized Contact | MARY A PANK Paralegal 502-394-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-01-16 |