| NPI | 1639206493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK LEWIS Hr Director 606-679-4782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2013-12-26 |