| NPI | 1386013001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETE M ANSERA Executive Director 502-653-7439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: KY 800195) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2021-08-18 |