| NPI | 1316780562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DECORA MARTIN Program Director 502-475-8958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2024-06-17 |