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Organization
CAMPBELL LODGE BOYS' HOME
Active
Organization
CAMPBELL LODGE BOYS' HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L SCHROTH MSW (EXECUTIVE DIRECTOR)
(859) 781-1214
Entity
Organization
Contact information
Practice address
5161 SKYLINE DR, HIGHLAND HEIGHTS, KY 41076-3545
(859) 781-1214
(859) 442-3473
Mailing address
5161 SKYLINE DR, HIGHLAND HEIGHTS, KY 41076-3545
(859) 781-1214
(859) 442-3473
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29100351
—
KY
Enumeration date
06/20/2006
Last updated
08/22/2020
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