| NPI | 1366594517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM GIBSON Executive Director 502-875-1545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KY 008132) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |