| NPI | 1376840314 |
|---|---|
| Other Name | MARK LANE |
| Entity Type | Organization |
| Authorized Contact | DEENA OMBRES Privacy Officer 502-394-2387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2011-02-25 |