| NPI | 1396952933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WHOBREY Provider Enrollment 502-630-7249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 251S00000X |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 376J00000X Homemaker | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-10-14 |