| NPI | 1740321082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTO A. PENNE-CASANOVA Sole Proprietor 502-899-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: KY 37074) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: KY 37074) |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2025-03-10 |