| NPI | 1952621005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FOSTER BEEUWKES Contract Manager 502-326-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2010-06-10 |