Organization
MDH MANAGEMENT GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DREW HAYNES (CHIEF EXECUTIVE OFFICER)
(502) 292-0734
Entity
Organization
Contact information
Practice address
12706 CRESTMOOR CIR, PROSPECT, KY 40059-9181
(502) 292-0734
Mailing address
12706 CRESTMOOR CIR, PROSPECT, KY 40059-9181
(502) 292-0734
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
33000621
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3300062100
—
KY
Enumeration date
01/04/2007
Last updated
08/22/2020
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