| NPI | 1548673270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA BRANDON BERTINO Dietitian 859-539-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-11-18 |