Healthcare Provider Details

I. General information

NPI: 1821193079
Provider Name (Legal Business Name): CHILD DEVELOPMENT CENTERS OF THE BLUEGRASS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 SPRINGHILL DR
LEXINGTON KY
40503-1233
US

IV. Provider business mailing address

465 SPRINGHILL DR
LEXINGTON KY
40503-1233
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-0549
  • Fax: 859-277-0807
Mailing address:
  • Phone: 859-278-0549
  • Fax: 859-277-0807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateKY

VIII. Authorized Official

Name: MR. ALAN JAY SIEGEL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 859-278-0549