Organization
MATTHEW 25 AIDS SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY WOOLFORK (CEO)
(270) 826-0200
Entity
Organization
Contact information
Practice address
452 OLD CORYDON RD, HENDERSON, KY 42420-4645
(270) 826-0200
(270) 826-0212
Mailing address
452 OLD CORYDON RD, HENDERSON, KY 42420-4645
(270) 826-0200
(270) 826-0212
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
740146
KY
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000246990
ANTHEM KY & IN
KY
05
—
200408870
—
IN
01
—
23130245
PASSPORT HEALTH PLAN
KY
05
—
78902822
—
KY
01
—
92-00380
UNITED HEALTHCARE
—
Enumeration date
06/09/2005
Last updated
01/16/2025
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