Healthcare Provider Details

I. General information

NPI: 1780559427
Provider Name (Legal Business Name): REDWOOD SCHOOL AND REHABILITATION CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 ORPHANAGE RD
FT MITCHELL KY
41017-3006
US

IV. Provider business mailing address

71 ORPHANAGE RD
FT MITCHELL KY
41017-3006
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 TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: DONEL AUTIN
Title or Position: CFO
Credential:
Phone: 513-377-3628