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General NPI Number Information
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NPI Number | 1407879349
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Entity Type | Organization
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Legal Business Name | WENDELL FOSTER'S CAMPUS FOR DEVELOPMENTAL DISABILITIES
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 815 TRIPLETT ST
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City | OWENSBORO
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State | KY
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Zip | 42303-3564
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Country | US
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Telephone | 270-683-4517
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Fax | 270-683-0079
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Provider Business Mailing Address
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Address Line | 815 TRIPLETT ST
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City | OWENSBORO
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State | KY
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Zip | 42303-3564
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Country | US
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Telephone | 270-683-4517
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Fax | 270-683-0079
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MS. BETH A SHEPHERD
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Credential | CPA
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Telephone | 270-852-1425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | KY
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