| NPI | 1609092113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HATTIE WAGNER President / CEO 502-259-9101 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: KY 101046) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 004650) |
| 225X00000X Occupational Therapist (Licence: KY R1071) | |
| 225X00000X Occupational Therapist (Licence: KY R3513) | |
| 235Z00000X Speech-Language Pathologist, (Licence: KY 2655) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2017-11-01 |