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General NPI Number Information
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NPI Number | 1386318616
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Entity Type | Organization
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Legal Business Name | PRESBYTERIAN CHILD WELFARE AGENCY, INC
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 1355 CEDAR POINT RD
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City | BUCKHORN
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State | KY
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Zip | 41721
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Country | US
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Telephone | 606-398-5077
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Fax |
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Provider Business Mailing Address
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Address Line | 116 BUCKHORN LN
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City | BUCKHORN
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State | KY
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Zip | 41721-8987
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Country | US
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Telephone | 606-398-7000
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | KENNITH MITCHELL SMITH
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Credential |
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Telephone | 606-398-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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