| NPI | 1881454981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONJALIA L TYUS President 502-500-4772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2024-03-20 |