| NPI | 1790232577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY ELAINE GRIMES Reimbursement Specialist 502-495-4953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: KY 101247) |
| Additional Taxonomies | 310500000X Intermediate Care Facility, Mental Illness (Licence: KY 101246) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2022-01-31 |