| NPI | 1831238526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA DIAZ Executive Director 270-866-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X Supports Brokerage (Licence: KY 089907) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |