Organization
KENNEDY INDIVIDUALIZED COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE KENNEDY (EXECUTIVE DIRECTOR)
(270) 674-5654
Entity
Organization
Contact information
Practice address
6337 SHAW RD, MELBER, KY 42069-8834
(270) 674-5654
(270) 674-5654
Mailing address
6337 SHAW RD, MELBER, KY 42069-8834
(270) 674-5654
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
142267
KY
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/14/2017
Last updated
07/14/2017
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