| NPI | 1699219162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY HASKINS Owner/Program Manager 502-682-7150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KY 7717) |
| Enumeration Date | 2016-12-18 |
| Last Update Date | 2017-01-09 |