| NPI | 1285209130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENA WATSON NUAZEE Co Owner/Executive Director 502-200-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2021-05-24 |