| NPI | 1336369644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN BANKS Administrator 859-806-1563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KY BD9026217) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2020-08-22 |