| NPI | 1902287832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH BATES Medical Director 502-638-4906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: KY 3009403) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2015-06-16 |