Healthcare Provider Details

I. General information

NPI: 1831122563
Provider Name (Legal Business Name): CENTERWELL CERTIFIED HEALTHCARE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2114 CHAMBER CENTER DR
FORT MITCHELL KY
41017-1669
US

IV. Provider business mailing address

PO BOX 1509
LOUISVILLE KY
40201-1509
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-5800
  • Fax:
Mailing address:
  • Phone: 913-814-2206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: SEAN PATRICK TURNER
Title or Position: VP REVENUE CYCLE
Credential:
Phone: 810-360-3133