| NPI | 1205990421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY E WOODY Executive Director 606-862-8066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KY 33000126) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2020-08-22 |