| NPI | 1922412873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE ANN GREENE Owner 502-836-3509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KY 1776) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2022-07-21 |