Healthcare Provider Details

I. General information

NPI: 1366713000
Provider Name (Legal Business Name): KENTUCKY RIVER FOOTHILLS DEVELOPMENT COUNCIL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 12TH ST
CLAY CITY KY
40312-8979
US

IV. Provider business mailing address

6021 ATWOOD DR
RICHMOND KY
40475-8320
US

V. Phone/Fax

Practice location:
  • Phone: 606-663-9011
  • Fax: 606-663-9012
Mailing address:
  • Phone: 859-624-2046
  • Fax: 859-624-2049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number700260
License Number StateKY

VIII. Authorized Official

Name: MR. DAVID ESTEPP
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 606-624-2046