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General NPI Number Information
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NPI Number | 1457355125
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Entity Type | Organization
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Legal Business Name | MATTHEW 25 AIDS SERVICES INC
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 452 OLD CORYDON RD
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City | HENDERSON
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State | KY
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Zip | 42420-4645
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Country | US
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Telephone | 270-826-0200
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Fax | 270-826-0212
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Provider Business Mailing Address
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Address Line | 452 OLD CORYDON RD
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City | HENDERSON
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State | KY
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Zip | 42420-4645
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Country | US
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Telephone | 270-826-0200
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Fax | 270-826-0212
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Authorized Official
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Title or Position | CEO
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Name | COURTNEY WOOLFORK
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Credential |
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Telephone | 270-826-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 740146
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License Number State | KY
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