Healthcare Provider Details

I. General information

NPI: 1790884187
Provider Name (Legal Business Name): HOMES WITH HEART, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 N MILES ST
ELIZABETHTOWN KY
42701-1875
US

IV. Provider business mailing address

519 N MILES ST
ELIZABETHTOWN KY
42701-1875
US

V. Phone/Fax

Practice location:
  • Phone: 270-763-0030
  • Fax:
Mailing address:
  • Phone: 270-763-0030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT LEE IRVING JR.
Title or Position: CEO
Credential: N.MD
Phone: 270-763-0030