| NPI | 1790281582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY D HOCKENSMITH Member 606-436-0081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2018-04-02 |