Organization
SHILOH CITY OF PEACE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAQUITA GASKINS (CEO)
(270) 300-1841
Entity
Organization
Contact information
Practice address
280 BRIGGS LN, VINE GROVE, KY 40175-9418
(270) 300-1841
Mailing address
280 BRIGGS LN, VINE GROVE, KY 40175-9418
(270) 300-1841
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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