| NPI | 1962529743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA MOUTACHOUIK President 502-299-4926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: KY 2170) |
| Enumeration Date | 2007-03-25 |
| Last Update Date | 2010-09-07 |