| NPI | 1922763861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDE EDWARD JOHNSON Executive Director 502-794-3082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2021-11-05 |
| Last Update Date | 2024-08-20 |