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General NPI Number Information
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NPI Number | 1215082466
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Entity Type | Organization
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Legal Business Name | KENTUCKY RIVER AREA DEV DIST
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 917 PERRY PARK ROAD
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City | HAZARD
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State | KY
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Zip | 41701
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Country | US
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Telephone | 606-436-3158
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Fax | 606-436-2144
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Provider Business Mailing Address
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Address Line | 917 PERRY PARK RD.
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City | HAZARD
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State | KY
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Zip | 41701
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Country | US
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Telephone | 606-436-3158
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Fax | 606-436-3154
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Authorized Official
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Title or Position | FINANCE OFFICER
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Name | MRS. MICHELLE L. ALLEN
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Credential |
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Telephone | 606-436-3158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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