| NPI | 1649484239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEENA OMBRES Privacy Officer 502-394-2387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 174400000X Specialist |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2008-07-16 |