# CAMPBELL LODGE BOYS' HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699710798
- **Authorized official:** MR. MICHAEL L SCHROTH MSW (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (859) 781-1214

## Contact information

- **Practice address:** 5161 SKYLINE DR, HIGHLAND HEIGHTS, KY 41076-3545
- **Practice address phone:** (859) 781-1214
- **Practice address fax:** (859) 442-3473
- **Mailing address:** 5161 SKYLINE DR, HIGHLAND HEIGHTS, KY 41076-3545
- **Mailing address phone:** (859) 781-1214
- **Mailing address fax:** (859) 442-3473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 06/20/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 29100351 | — | KY |