Organization
COMMUNITY LIVING IN KENTUCKY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA KIRK (REVENUE CYCLE MANAGER)
(615) 880-5782
Entity
Organization
Contact information
Practice address
634 N 12TH ST, MURRAY, KY 42071-1651
(615) 569-1314
(615) 577-5654
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1146
(615) 696-6761
(615) 880-5782
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
174400000X
Specialist
—
KY
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225C00000X
Rehabilitation Counselor
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117801-000
OCCUPATIONAL LICENSE
KY
05
—
7100125920
—
KY
05
—
7100234300
—
KY
05
—
7100308510
—
KY
05
—
7100309160
—
KY
05
—
7100310590
—
KY
05
—
7100318650
—
KY
Enumeration date
03/22/2010
Last updated
09/18/2023
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