| NPI | 1912033879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK DAVIS Executive Director 502-493-2512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2015-03-11 |