Healthcare Provider Details

I. General information

NPI: 1376431072
Provider Name (Legal Business Name): KENTUCKY RIVER FOOTHILLS DEVELOPMENT COUNCIL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 12TH ST
CLAY CITY KY
40312-8981
US

IV. Provider business mailing address

176 12TH ST
CLAY CITY KY
40312-8981
US

V. Phone/Fax

Practice location:
  • Phone: 859-972-7038
  • Fax:
Mailing address:
  • Phone: 859-972-7038
  • Fax:

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 Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID ESTEPP
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 859-624-2046