| NPI | 1437490448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATINA BRUCE Program Director 502-395-8758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2013-05-14 |