| NPI | 1700479201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETENEGUS (LETE) M ANSERA Exc. Director 502-690-2010 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2025-06-24 |