| NPI | 1871841114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CLARK Managing Member 859-940-6613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2012-12-13 |