| NPI | 1972668150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA EDGE Program Manager 270-686-8123 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care (Licence: KY 750047) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2008-06-23 |