| NPI | 1881076461 |
|---|---|
| Former Legal Business Name | THERAPEUTIC VILLAGE |
| Entity Type | Organization |
| Authorized Contact | CHERYL LYNN ELAM Owner 859-595-5860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2016-04-14 |