| NPI | 1568004976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRY BURRY President 502-244-6820 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-17 |