| NPI | 1235588724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA LONG PT 502-552-3530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: KY 002535) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2016-06-06 |