Healthcare Provider Details
I. General information
NPI: 1285774430
Provider Name (Legal Business Name): WATCH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/07/2007
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
702 MAIN ST
MURRAY KY
42071-1943
US
IV. Provider business mailing address
702 MAIN ST
MURRAY KY
42071-1943
US
V. Phone/Fax
- Phone: 270-759-1965
- Fax: 270-761-1453
- Phone: 270-759-1965
- Fax: 270-761-1453
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
PATRICE
KLOBE
Title or Position: BOOKKEEPER
Credential:
Phone: 270-759-1965