| NPI | 1427829605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA CARDELL-LOVE Owner/ Billing Manager 502-489-2798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-01-15 |