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General NPI Number Information
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NPI Number | 1841572914
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Entity Type | Organization
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Legal Business Name | DIOCESAN CATHOLIC CHILDREN'S HOME
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 75 ORPHANAGE RD
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City | FT MITCHELL
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State | KY
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Zip | 41017-3006
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Country | US
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Telephone | 859-331-2040
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Fax | 859-344-5022
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Provider Business Mailing Address
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Address Line | 75 ORPHANAGE RD P. O. BOX # 17007
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City | FT MITCHELL
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State | KY
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Zip | 41017-3006
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Country | US
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Telephone | 859-331-2040
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Fax | 859-344-5022
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Authorized Official
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Title or Position | DIRECTOR OF CHILDREN'S SERVICES
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Name | MR. JOHN WALTER ROSS
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Credential | LCSW
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Telephone | 859-331-2040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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