| NPI | 1275804577 |
|---|---|
| Other Name | PONDEROSA GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | DEENA G. OMBRES Assoc. Gen. Counsel/Privacy Officer 502-394-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-01-18 |