Healthcare Provider Details

I. General information

NPI: 1598364333
Provider Name (Legal Business Name): REDWOOD SCHOOL & REHABILITATION CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2020
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 ORPHANAGE RD
FORT MITCHELL KY
41017-3099
US

IV. Provider business mailing address

71 ORPHANAGE RD
FORT MITCHELL KY
41017-3099
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-0880
  • Fax: 855-704-1573
Mailing address:
  • Phone: 859-331-0880
  • Fax: 855-704-1573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MRS. PAM GREEN
Title or Position: CEO
Credential:
Phone: 859-331-0880