Organization
PRO-CARE HOME HEALTH LIMITED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN BAILEY (DIRECTOR OF INFORMATION SYSTEMS)
(270) 298-3112
Entity
Organization
Contact information
Practice address
122 W UNION ST, HARTFORD, KY 42347-1416
(270) 298-3112
Mailing address
PO BOX 109, HARTFORD, KY 42347-0109
(270) 298-3112
(270) 298-4766
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
150138
KY
251E00000X
Home Health Agency
Primary
150138
KY
273Y00000X
Rehabilitation Hospital Unit
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34000265
—
KY
01
—
42000158
WAIVER
KY
01
—
45003522
KY EPSDT
KY
Enumeration date
05/31/2005
Last updated
03/01/2010
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