| NPI | 1376161810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN SMITH Manager 502-244-9859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |