Healthcare Provider Details

I. General information

NPI: 1447303045
Provider Name (Legal Business Name): CHRISTIAN APPALACHIAN PROJECT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 BEITING LANE
MT. VERNON KY
40456
US

IV. Provider business mailing address

25 BEITING LANE
MT. VERNON KY
40456
US

V. Phone/Fax

Practice location:
  • Phone: 606-256-0539
  • Fax: 606-256-0694
Mailing address:
  • Phone: 606-256-0539
  • Fax: 606-256-0694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number33001033
License Number StateKY

VIII. Authorized Official

Name: MR. LINVILLE ROSE
Title or Position: ASSISTANT DIRECTOR
Credential:
Phone: 606-256-0539