| NPI | 1861822314 |
|---|---|
| Other Name | ENOCH GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | ANGIE MATTINGLY Provider Enrollment Manager 502-394-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2021-06-04 |