| NPI | 1417300088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL BOAMAH CEO 270-320-1101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KY 164686) |
| Additional Taxonomies | 251C00000X (Licence: KY 164686) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-07-19 |