| NPI | 1417250077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD EDWARD GOEPPER Registered Agent 502-254-7994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2010-12-20 |