Organization
CHRISTIAN CARE COMMUNITIES, INC.
Active
Other names
Community Youth Home - West
Organization subpart
No
Provider details
NPI number
Authorized official
MR. W RICHARD MARSHALL (VICE PRESIDENT CFO)
(502) 254-4200
Entity
Organization
Contact information
Practice address
1151 PERRYVILLE RD, DANVILLE, KY 40422-1306
(859) 236-5507
Mailing address
12700 SHELBYVILLE RD, THE CUMBERLAND BUILDING, LOUISVILLE, KY 40243-1576
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
04000014
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04000014
—
KY
Enumeration date
03/22/2007
Last updated
08/22/2020
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