| NPI | 1245778893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANASTACIA MARIE HUDGINS Lpa 606-383-0728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KY LPA) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2017-02-03 |