| NPI | 1518138502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS BURKE Administrator 270-886-9915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: KY 087878) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-03-18 |