Commonwealth of Kentucky

NPI #1689652513 in Mt Washington, Kentucky

Provider Information

NPI Number
1689652513
Entity Type
Organization
Organization Name
Commonwealth of Kentucky
Subpart
Yes (part of a larger organization)
Parent Organization
COMMONWEALTH OF KENTUCKY
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Dec 30, 2005
Last Updated
Aug 7, 2024

Practice Location

Address
210 MEADOWS DR
ZIP Code
40047-6013
Phone
(502) 361-2301

Authorized Official

Name
JENNIFER MOORE
Title
ASSISTANT DIRECTOR
Phone
(502) 782-6117

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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