Organization
MASONIC HOMES OF KENTUCKY PEDIATRIC DAYCARE INC
Active
Parent organization
MASONIC HOMES OF KENTUCKY INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MASONIC HOMES OF KENTUCKY INC
Authorized official
KIM BODEN (EXECUTIVE DIRECTOR)
(502) 753-8224
Entity
Organization
Contact information
Practice address
330 MASONIC HOME DR, MASONIC HOME, KY 40041-9000
(502) 753-8224
(502) 753-8223
Mailing address
330 MASONIC HOME DR, MASONIC HOME, KY 40041-9000
(502) 753-8224
(502) 753-8223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/19/2012
Last updated
06/19/2012
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