| NPI | 1841763323 |
|---|---|
| Doing Business As | KENTUCKYCARE 128 |
| Entity Type | Organization |
| Authorized Contact | STEVEN COLLIER CEO 870-347-2534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2021-01-20 |