| NPI | 1710173349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA JETT Owner 502-349-0105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: KY 3072pky) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2008-02-22 |