| NPI | 1285754424 |
|---|---|
| Other Name | EC CHAR LEAVES |
| Entity Type | Organization |
| Authorized Contact | ANGIE MATTINGLY Provider Enrollment Mgr 502-381-3579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2021-06-01 |