| NPI | 1861099087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA BRYANT Interim CEO/CAO 859-404-7686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |