| NPI | 1356893630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LYNN MATTINGLY Owner 270-402-5601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KY LPCPCC00223155) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 261QC1500X Clinic/Center Community Health | |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2020-12-17 |