| NPI | 1528914496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY SHUMAKE President 502-415-2334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2026-03-04 |
| Last Update Date | 2026-03-04 |