Healthcare Provider Details

I. General information

NPI: 1104966357
Provider Name (Legal Business Name): OPPORTUNITY CENTER OF OWENSBORO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E BYERS AVE
OWENSBORO KY
42303
US

IV. Provider business mailing address

PO BOX 1833
OWENSBORO KY
42302-1833
US

V. Phone/Fax

Practice location:
  • Phone: 270-645-5004
  • Fax: 270-685-2036
Mailing address:
  • Phone: 270-645-5004
  • Fax: 270-685-2036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateKY

VIII. Authorized Official

Name: ROSEMARY D CONDER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 270-645-5004