Healthcare Provider Details

I. General information

NPI: 1235113713
Provider Name (Legal Business Name): WHITLEY COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 03/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

368 PENNY LN
WILLIAMSBURG KY
40769-7481
US

IV. Provider business mailing address

368 PENNY LN
WILLIAMSBURG KY
40769-7481
US

V. Phone/Fax

Practice location:
  • Phone: 606-549-0886
  • Fax: 606-549-2665
Mailing address:
  • Phone: 606-549-0886
  • Fax: 606-549-2665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number150034
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number150034
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number150034
License Number StateKY

VIII. Authorized Official

Name: MRS. CYNTHIA GAIL TIMPERIO
Title or Position: DIRECTOR OF ADMINISTRATIVE SERVICES
Credential:
Phone: 606-549-3380