| NPI | 1861512717 |
|---|---|
| Other Name | STX HUNTERS RAVEN |
| Entity Type | Organization |
| Authorized Contact | DEENA OMBRES Privacy Officer 502-394-2387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded |
| Enumeration Date | 2007-04-01 |
| Last Update Date | 2008-07-18 |