| NPI | 1730744186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY A PANK Paralegal 502-394-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |