NPI | 1467201590 |
---|---|
Entity Type | Organization |
Authorized Contact | JACQUELINE SANDERS Credentialing Manager 502-630-2036 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Enumeration Date | 2024-05-13 |
Last Update Date | 2024-05-13 |