| NPI | 1619013901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA DAWN KEELIN Doctor 606-928-3364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: KY 4794) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |