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General NPI Number Information
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NPI Number | 1104237049
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Entity Type | Organization
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Legal Business Name | KVC BEHAVIORAL HEALTHCARE
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Dates
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Enumeration Date | 05/14/2014
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Last Update Date | 05/14/2014
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Provider Practice Location Address
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Address Line | 900 BEASLEY ST SUITE 120
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City | LEXINGTON
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State | KY
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Zip | 40509-4266
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Country | US
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Telephone | 859-254-1035
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Fax | 859-254-2075
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Provider Business Mailing Address
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Address Line | 900 BEASLEY ST SUITE 120
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City | LEXINGTON
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State | KY
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Zip | 40509-4266
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Country | US
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Telephone | 859-254-1035
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Fax | 859-254-2075
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Authorized Official
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Title or Position | FPP SPECIALIST
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Name | MS. JESSICA GARRETT
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Credential | BSW
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Telephone | 317-840-3434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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