| NPI | 1518104785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA LUSTER Billing Manager 502-543-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 1394) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2009-01-09 |