Organization
CENTRAL KENTUCKY SUPPORTIVE LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONNIE C CLARK (CONTROLLER)
(606) 674-6962
Entity
Organization
Contact information
Practice address
650 PEELED OAK RD, OWINGSVILLE, KY 40360-8047
(606) 674-6962
Mailing address
650 PEELED OAK RD, OWINGSVILLE, KY 40360-8047
(606) 674-6962
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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