Healthcare Provider Details
I. General information
NPI: 1457304123
Provider Name (Legal Business Name): H2 REHABILITATION SERVICES OF KENTUCKY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2006
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
116 MERIDIAN WAY STE 9
RICHMOND KY
40475-2876
US
IV. Provider business mailing address
PO BOX 932184
ATLANTA GA
31193-4912
US
V. Phone/Fax
- Phone: 859-623-6334
- Fax: 859-623-6336
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | 100870 |
| License Number State | KY |
VIII. Authorized Official
Name:
AMANDA
STREETER
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 800-699-9395