| NPI | 1932842226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH NALLEY CEO 502-489-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2022-04-15 |
| Last Update Date | 2022-04-15 |