| NPI | 1619443264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE MATTINGLY Mgr Provider Enrollment 502-381-3579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251G00000X Hospice Care, Community Based |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2020-08-21 |