| NPI | 1720647142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARREATTA DEINSE BLACKMON Owner 502-916-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 261QH0700X Clinic/Center, Hearing and Speech | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2024-05-05 |