Organization
KENTUCKY RIVER AREA DEV DIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE L. ALLEN (FINANCE OFFICER)
(606) 436-3158
Entity
Organization
Contact information
Practice address
917 PERRY PARK ROAD, HAZARD, KY 41701
(606) 436-3158
(606) 436-2144
Mailing address
917 PERRY PARK RD., HAZARD, KY 41701
(606) 436-3158
(606) 436-3154
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
KY
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700083700
—
KY
05
—
3300146200
—
KY
05
—
4399612300
—
KY
Enumeration date
01/25/2007
Last updated
12/01/2010
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