| NPI | 1407745243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELANAM GBEGNON Owner 502-618-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-06-28 |
| Last Update Date | 2025-06-28 |