| NPI | 1225333743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTIE MATZEK President 502-778-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: KY LAL000152) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 1223G0001X Dentist, General Practice | |
| 207R00000X Internal Medicine | |
| 363A00000X Physician Assistant | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2024-08-07 |