| NPI | 1285519504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P SULLIVAN Owner 502-451-5121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2025-08-06 |
| Last Update Date | 2025-08-06 |