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General NPI Number Information
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NPI Number | 1790454015
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Entity Type | Organization
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Legal Business Name | A PLACE CALLED HOME KY 1
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Dates
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Enumeration Date | 09/09/2021
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 1406 N 12TH ST STE C
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City | MURRAY
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State | KY
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Zip | 42071-3531
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Country | US
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Telephone | 270-753-5990
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Fax | 270-753-5994
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Provider Business Mailing Address
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Address Line | 1406 N 12TH ST STE C
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City | MURRAY
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State | KY
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Zip | 42071-3531
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Country | US
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Telephone | 270-753-5990
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Fax | 270-753-5994
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LEE ANNE TEAGUE
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Credential | MSSW
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Telephone | 270-753-5990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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