| NPI | 1659815629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER POLLARD Owner 502-592-4167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KY 171380) |
| Enumeration Date | 2016-12-11 |
| Last Update Date | 2016-12-11 |