Healthcare Provider Details

I. General information

NPI: 1386979615
Provider Name (Legal Business Name): CHILDREN'S HOME OF NORTHERN KENTUCKY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HOME RD
COVINGTON KY
41011
US

IV. Provider business mailing address

200 HOME RD
COVINGTON KY
41011-1942
US

V. Phone/Fax

Practice location:
  • Phone: 859-261-8768
  • Fax: 859-291-2431
Mailing address:
  • Phone: 859-261-8768
  • Fax: 859-291-2431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number800129
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number500488
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number950033
License Number StateKY

VIII. Authorized Official

Name: JULIE RAIA
Title or Position: CHIEF STRATEGY OFFICER
Credential:
Phone: 859-292-4162