Organization
IRVCO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRVIN W. SMITH ED.D. (EXECUTIVE DIRECTOR)
(859) 252-3679
Entity
Organization
Contact information
Practice address
263 BOILING SPRINGS DR, LEXINGTON, KY 40511-2103
(859) 252-3679
(859) 252-3679
Mailing address
263 BOILING SPRINGS DR, LEXINGTON, KY 40511-2103
(859) 252-3679
(859) 252-3679
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33000530
—
KY
Enumeration date
12/22/2006
Last updated
08/22/2020
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