Organization
KENTUCKY CUSTOM CARE PROFESSIONALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY FENWICK CPA (OWNER)
(502) 331-1085
Entity
Organization
Contact information
Practice address
3200 PATTON RD, BOSTON, KY 40107-4010
(502) 331-1085
Mailing address
3200 PATTON RD, BOSTON, KY 40107-8700
(502) 331-1085
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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