NPI | 1831316595 |
---|---|
Entity Type | Organization |
Authorized Contact | JIM DEWAYNE HISLE President 502-428-9037 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KY 7100010990) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
251C00000X Day Training, Developmentally Disabled Services | |
261Q00000X Clinic/Center | |
225100000X Physical Therapist | |
225X00000X Occupational Therapist | |
261QA0600X Clinic/Center, Adult Day Care (Licence: KY 7100233390) | |
261QD1600X Clinic/Center, Developmental Disabilities | |
261QP2000X Clinic/Center, Physical Therapy (Licence: KY 7100199960) | |
261QR0400X Clinic/Center, Rehabilitation | |
Enumeration Date | 2007-04-20 |
Last Update Date | 2018-07-12 |