| NPI | 1649353400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMY LEE LOUISVILLE Medical Director/CEO 863-875-4864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2011-05-10 |