Healthcare Provider Details

I. General information

NPI: 1407879349
Provider Name (Legal Business Name): WENDELL FOSTER'S CAMPUS FOR DEVELOPMENTAL DISABILITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 TRIPLETT ST
OWENSBORO KY
42303-3564
US

IV. Provider business mailing address

815 TRIPLETT ST
OWENSBORO KY
42303-3564
US

V. Phone/Fax

Practice location:
  • Phone: 270-683-4517
  • Fax: 270-683-0079
Mailing address:
  • Phone: 270-683-4517
  • Fax: 270-852-1490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateKY
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateKY

VIII. Authorized Official

Name: SANDY HAYDEN
Title or Position: VICE PRESIDENT
Credential:
Phone: 270-852-1439