Phoenix Way, LLC
NPI #1114345121 in Campbellsville, Kentucky
Provider Information
- NPI Number
- 1114345121
- Entity Type
- Organization
- Organization Name
- Phoenix Way, LLC
- Primary Specialty
- Day Training, Developmentally Disabled Services
- Enumeration Date
- Apr 7, 2014
- Last Updated
- Dec 2, 2014
Practice Location
- Address
- 4142 OLD COLUMBIA RD
- City
- Campbellsville
- State
- Kentucky
- ZIP Code
- 42718-9352
- Phone
- (270) 283-4352
Authorized Official
- Name
- LUCRETIA RENE VAUGHN
- Title
- PROGRAM DIRECTOR
- Phone
- (270) 789-9564
Specialties & Taxonomy Codes
| Specialty |
|---|
| Day Training, Developmentally Disabled Services |
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