| NPI | 1376052308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA WHEELER General Manager 859-567-1271 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2017-09-21 |