Healthcare Provider Details

I. General information

NPI: 1356528699
Provider Name (Legal Business Name): CHILDREN'S HEALTH FIRST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1444 WOODBRIDGE TRL
OWENSBORO KY
42303-7546
US

IV. Provider business mailing address

2826 HOOCK AVE
LOUISVILLE KY
40205-2914
US

V. Phone/Fax

Practice location:
  • Phone: 270-929-7888
  • Fax:
Mailing address:
  • Phone: 502-459-2397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JODY V ROGERS
Title or Position: MEMBER
Credential:
Phone: 502-459-2397