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General NPI Number Information
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NPI Number | 1043433444
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Entity Type | Organization
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Legal Business Name | KNOX CO. YMCA SENIOR SERVICE
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2009 PROSPECT AVE
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City | VINCENNES
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State | IN
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Zip | 47591-5666
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Country | US
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Telephone | 812-882-2285
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Fax | 812-882-2186
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Provider Business Mailing Address
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Address Line | 2009 PROSPECT AVE
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City | VINCENNES
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State | IN
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Zip | 47591-5666
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Country | US
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Telephone | 812-882-2285
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Fax | 812-882-2186
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Authorized Official
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Title or Position | EX. DIRECTOR
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Name | MRS. NOLA E DAVIS
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Credential |
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Telephone | 812-882-2285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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