Organization
WILDERNESS TRACE CHILD DEVELOPMENT CENTER
Active
Organization
WILDERNESS TRACE CHILD DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LIBBY SUTTLES (EXECUTIVE DIRECTOR)
(859) 236-0878
Entity
Organization
Contact information
Practice address
409 STEWARTS LN N, DANVILLE, KY 40422-8825
(859) 236-0878
(859) 236-0878
Mailing address
409 STEWARTS LN N, DANVILLE, KY 40422-8825
(859) 236-0878
(859) 236-3570
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251300000X
Local Education Agency (LEA)
354928
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00153
FIRST STEPS PROVIDER NUMB
KY
05
—
7100454490
—
KY
Enumeration date
05/21/2007
Last updated
05/10/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up