| NPI | 1982865556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TORI MURDEN MCCLURE President 502-588-7164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: KY 101189) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 252Y00000X Early Intervention Provider Agency | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 251S00000X Community/Behavioral Health (Licence: KY 101189) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2015-06-10 |