Healthcare Provider Details
I. General information
NPI: 1033937594
Provider Name (Legal Business Name): OPPORTUNITY CENTER OF OWENSBORO, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2024
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1101 EAST BYERS AVE
OWENSBORO KY
42303
US
IV. Provider business mailing address
PO BOX 1833
OWENSBORO KY
42302-1833
US
V. Phone/Fax
- Phone: 270-645-5004
- Fax:
- Phone: 270-645-5004
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROSEMARY
CONDER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 270-645-5004