| NPI | 1932475712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY SULLIVAN Owner 502-396-1472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: KY KY-R2746) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2012-03-27 |