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General NPI Number Information
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NPI Number | 1740320084
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Entity Type | Organization
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Legal Business Name | OUR FRIENDS PLACE, INC.
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 316 N HILL ST
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City | LONDON
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State | KY
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Zip | 40741-1338
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Country | US
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Telephone | 606-877-2631
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Fax | 606-877-2635
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Provider Business Mailing Address
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Address Line | PO BOX 2558
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City | LONDON
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State | KY
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Zip | 40743-2558
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Country | US
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Telephone | 606-877-2631
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Fax | 606-877-2635
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Authorized Official
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Title or Position | OWNER
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Name | MATT JONES
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Credential | PT
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Telephone | 606-877-2631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | KY
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