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NPI Code Detail

MEDICARE: EASTER SEALS WEST KENTUCKY, INC.

MEDICARE: EASTER SEALS WEST KENTUCKY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
2251300000XLocal Education Agency (LEA)
3261QM3000XMedically Fragile Infants and Children Day Care
4324500000XSubstance Abuse Rehabilitation Facility
5103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
145229952OTHERKYEPSDT
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720123870
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTER SEALS WEST KENTUCKY, INC.
Provider Business Mailing Address
First Line : 801 N 29TH ST
Second Line :
City : PADUCAH
State : KY
Zip : 42001-4056
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 619 N 30TH ST
Second Line :
City : PADUCAH
State : KY
Zip : 42001-4047
Country : US
Telephone Number : 270-444-9687
Fax Number :
Authorized Official
Title or Position : OPERATIONS MANAGER
Name : LEE HENRY
Credential :
Telephone Number : 270-444-7898
Provider Enumeration Date : 02/20/2007
Last Update Date : 12/17/2024

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Directions to “EASTER SEALS WEST KENTUCKY, INC. ” Practice Location

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