| Document Date: 2015-01-30 14:30:48
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Company Profit Individual X County Nonprofit Partnership X Corporation / / Facility Residential Hospice / Ownership TYPE OF FACILITY / Psychiatric Residential Treatment Facility / Date facility / / Organization Ownership TYPE OF FACILITY OR SERVICE / office of Inspector General / Chemical Dependency Treatment Service / Fire Marshal’s Office / / Position officer / MARSHAL / Fire Marshal / director of the corporation / Administrator / / ProvinceOrState Kentucky / /
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Application for License to Operate a Chemical Dependency Treatment Service, Group Home, Psychiatric Residential Treatment Facility, or Residential Hospice Facility OIG 002 – June 2014 Edition I.