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General NPI Number Information
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NPI Number | 1104964477
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Entity Type | Organization
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Legal Business Name | THE GERI-YOUNG HOUSE, INC.
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 65 E MAIN ST
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City | BEATTYVILLE
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State | KY
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Zip | 41311-9246
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Country | US
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Telephone | 606-464-2022
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Fax |
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Provider Business Mailing Address
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Address Line | 65 E MAIN ST
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City | BEATTYVILLE
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State | KY
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Zip | 41311-9246
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Country | US
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Telephone | 606-464-2022
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MRS. CYNTHIA G STAMPER
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Credential | DIRECTOR
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Telephone | 606-464-2022
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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 | 750051
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License Number State | KY
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