| NPI | 1609188689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JOHN SIDERS Member Owner 859-229-0085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2016-09-26 |