| NPI | 1770636797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA JEAN SHELBURNE President 502-265-0184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: KY 4155) |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2020-08-22 |