Healthcare Provider Details

I. General information

NPI: 1245535426
Provider Name (Legal Business Name): KPI THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2011
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date: 05/22/2019
Reactivation Date: 10/03/2019

III. Provider practice location address

436 HOUSTON OAKS DR
PARIS KY
40361-2704
US

IV. Provider business mailing address

436 HOUSTON OAKS DR
PARIS KY
40361-2704
US

V. Phone/Fax

Practice location:
  • Phone: 606-584-1169
  • Fax: 800-584-1465
Mailing address:
  • Phone: 606-584-1169
  • Fax: 800-584-1465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHELIA BESS
Title or Position: PRESIDENT
Credential:
Phone: 606-584-1169