| NPI | 1457819195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE M COCHRAN Board Member 502-664-7987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-03-12 |