| NPI | 1922492230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELETE MORELAND Irector 502-804-8003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3005483) | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LW0102X Nurse Practitioner, Women's Health | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2025-07-16 |