| NPI | 1891012811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY TUTTLE Member 859-537-7332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: KY 40860) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2019-12-23 |