NPI | 1700264918 |
---|---|
Entity Type | Organization |
Authorized Contact | BENJAMIN DORSEY FERGUSON Clinical Director/Supervisor 606-506-5077 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: KY 810470) |
Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: KY 1361) |
Enumeration Date | 2015-05-08 |
Last Update Date | 2018-03-17 |