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General NPI Number Information
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NPI Number | 1134434004
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Entity Type | Organization
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Legal Business Name | THE POINT ARC OF NORTHERN KENTUCKY
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Dates
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Enumeration Date | 08/16/2010
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 104 W PIKE ST
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City | COVINGTON
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State | KY
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Zip | 41011-2310
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Country | US
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Telephone | 859-491-9191
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Fax | 859-491-0763
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Provider Business Mailing Address
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Address Line | 104 W PIKE ST
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City | COVINGTON
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State | KY
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Zip | 41011-2310
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Country | US
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Telephone | 859-491-9191
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Fax | 859-491-0763
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Authorized Official
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Title or Position | RESIDENTIAL PROGRAM EXECUTIVE DIREC
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Name | MS. GALE BRINKMAN
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Credential | BACHELORS DEGREE
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Telephone | 859-491-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 850084
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License Number State | KY
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