Organization
OWENSBORO HABILITATION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN R PARKER MBA (BUSINESS OFFICE MANAGER)
(270) 302-6538
Entity
Organization
Contact information
Practice address
1620 FREDERICA ST, OWENSBORO, KY 42301-4807
(270) 302-6538
Mailing address
1620 FREDERICA ST, OWENSBORO, KY 42301-4807
(270) 302-6538
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
Other
Enumeration date
09/06/2007
Last updated
09/11/2007
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