| NPI | 1992906150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISHA CONNOR Director Licensure And Enrollment 502-630-7421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2025-07-08 |