| NPI | 1962083014 |
|---|---|
| Doing Business As | GLEN DALE CENTER |
| Entity Type | Organization |
| Authorized Contact | SHARON C' DE BACA Executive Assistant To President 502-538-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2022-10-25 |