| NPI | 1487038766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA BOWEN Program Director 502-939-0278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: KY 0811) |
| Additional Taxonomies | 251B00000X Case Management (Licence: KY 0811) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2015-07-16 |