| NPI | 1538935325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA BALL Owner 859-475-3247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2023-12-11 |