| NPI | 1215423827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON L FORD Owner 859-300-9760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2022-10-03 |