| NPI | 1588042097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALIE FARRIS Office Manager 502-414-4557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-05-16 |
| Last Update Date | 2015-05-16 |