| NPI | 1316111867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE MATTINGLY Provider Enrollment Manager 502-630-7425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2020-03-05 |