| NPI | 1518733138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN THORNSBERRY COO 502-439-2248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2024-11-25 |