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Organization
KENTUCKY CUSTOM CARE PROFESSIONALS
Active
Organization
KENTUCKY CUSTOM CARE PROFESSIONALS
Active
Other names
Kentucky Custom Care Professionals
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY FENWICK CPA (OWNER)
(502) 331-1085
Entity
Organization
Contact information
Practice address
3200 PATTON RD, BOSTON, KY 40107-8700
(502) 331-1085
Mailing address
3200 PATTON RD, BOSTON, KY 40107-8700
(502) 331-1085
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
—
311Z00000X
Custodial Care Facility
Primary
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
11/11/2019
Last updated
11/12/2019
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