| NPI | 1417458795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE K. DILLON Assistant Secretary 502-596-7220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2019-04-30 |