Healthcare Provider Details

I. General information

NPI: 1346402138
Provider Name (Legal Business Name): RISING STAR STUDIOS OF KENTUCKY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PHILADELPHIA ST
COVINGTON KY
41011-1244
US

IV. Provider business mailing address

3611 DECOURSEY AVE
COVINGTON KY
41015-1437
US

V. Phone/Fax

Practice location:
  • Phone: 859-291-2999
  • Fax: 859-291-2999
Mailing address:
  • Phone: 859-291-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBARA BONAR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 859-291-2999