Healthcare Provider Details

I. General information

NPI: 1548307390
Provider Name (Legal Business Name): CHRANSYE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 04/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1043 CENTER DR
RICHMOND KY
40475-3838
US

IV. Provider business mailing address

1043 CENTER DR
RICHMOND KY
40475-3838
US

V. Phone/Fax

Practice location:
  • Phone: 859-626-1042
  • Fax: 859-626-1146
Mailing address:
  • Phone: 859-626-1042
  • Fax: 859-626-1146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateKY

VIII. Authorized Official

Name: MRS. DINA MULLINS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 859-626-1042