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Organization
WESTERN KY REGIONAL MHMR BOARD INC
Active
Organization
WESTERN KY REGIONAL MHMR BOARD INC
Active
Other names
Four Rivers Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRETCHEN E. ROOF (PRESIDENT/CEO)
(270) 442-7121
Entity
Organization
Contact information
Practice address
425 BROADWAY, SUITE 201, PADUCAH, KY 42001
(270) 442-7121
(270) 443-9692
Mailing address
425 BROADWAY ST STE 201, PADUCAH, KY 42001-0713
(270) 442-7121
(270) 443-9692
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
800001
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000057108
ANTHEM BCBS
KY
05
—
27001015
—
KY
05
—
28001014
—
KY
05
—
29100946
—
KY
05
—
29100948
—
KY
05
—
30601017
—
KY
05
—
33900242
—
KY
Enumeration date
07/14/2006
Last updated
02/11/2026
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