| NPI | 1578749040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN MARIE TARVER-WILSON CEO/Social Worker/ 502-848-4225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: KY 3253) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-02-11 |