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General NPI Number Information
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NPI Number | 1972120152
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Entity Type | Organization
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Legal Business Name | ENGAGE SUPPORT SERVICES, LLC
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Dates
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Enumeration Date | 07/03/2020
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 3306 CLAYS MILL RD STE 207
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City | LEXINGTON
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State | KY
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Zip | 40503-3483
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Country | US
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Telephone | 859-036-1983
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Fax | 859-303-6199
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Provider Business Mailing Address
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Address Line | 2526 REGENCY RD STE 140
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City | LEXINGTON
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State | KY
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Zip | 40503-2996
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Country | US
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Telephone | 859-687-9291
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. NICO KELLY
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Credential |
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Telephone | 859-489-5910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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