| NPI | 1578208724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA ROGERS Administrator 502-214-3210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2022-05-02 |