Organization
GREEN RIVER AREA DEVELOPMENT DISTRICT
Active
Other names
Green River Area Agency on Aging
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JITEN SHAH (EXECUTIVE DIRECTOR)
(270) 926-4433
Entity
Organization
Contact information
Practice address
300 GRADD WAY, OWENSBORO, KY 42301-8696
(270) 926-4433
(270) 684-0714
Mailing address
300 GRADD WAY, OWENSBORO, KY 42301-8696
(270) 926-4433
(270) 684-0714
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
KY
251C00000X
Developmentally Disabled Services Day Training Agency
—
KY
251X00000X
Supports Brokerage Agency
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17000720
—
KY
05
—
33001371
—
KY
05
—
43996032
—
KY
Enumeration date
04/19/2007
Last updated
10/04/2013
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