| NPI | 1841726817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY NICOLE IDLEWINE Qidp/Counselor 606-677-4068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KY 127180) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |