| NPI | 1538454020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY HENDERSON Program Aministrator 859-887-0325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 101YA0400X) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: KY 324500000X) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2011-06-13 |