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General NPI Number Information
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NPI Number | 1790635696
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Entity Type | Organization
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Legal Business Name | COMMUNITY INCLUSION LLC
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 320 BLUEBIRD DR
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City | RUSSELL
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State | KY
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Zip | 41169-1568
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Country | US
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Telephone | 606-694-1797
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Fax |
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Provider Business Mailing Address
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Address Line | 320 BLUEBIRD DR
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City | RUSSELL
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State | KY
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Zip | 41169-1568
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Country | US
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Telephone | 606-694-1797
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TONI MULLINS
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Credential | MSN, RN
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Telephone | 606-694-1797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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