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General NPI Number Information
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NPI Number | 1912917543
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Entity Type | Organization
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Legal Business Name | KENTUCKY RIVER FOOTHILLS DEVELOPMENT COUNCIL, INC.
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 209 RIVER DR
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City | IRVINE
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State | KY
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Zip | 40336-1142
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Country | US
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Telephone | 606-723-6629
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Fax | 606-723-9726
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Provider Business Mailing Address
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Address Line | 209 RIVER DR
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City | IRVINE
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State | KY
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Zip | 40336-1142
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Country | US
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Telephone | 606-663-9011
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Fax | 606-663-9012
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | VICKI M JOZEFOWICZ
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Credential |
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Telephone | 859-624-2046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 720280
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License Number State | KY
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