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Organization
BARNABAS HOME INC
Active
Organization
BARNABAS HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZA DIANE CLONTZ LPCC LCADC CSS (CLINICAL TREATMENT DIRECTOR)
(606) 364-3640
Entity
Organization
Contact information
Practice address
95 CAMPUS DRIVE, ANNVILLE, KY 40402
(606) 364-3640
(606) 364-2534
Mailing address
PO BOX 209, ANNVILLE, KY 40402-0209
(606) 364-3640
(606) 364-2534
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100283130
—
KY
Enumeration date
08/22/2019
Last updated
08/22/2019
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