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Organization

COMMONWEALTH OF KENTUCKY

Active
Parent organization
COMMONWEALTH OF KENTUCKY
Other names
Oakwood ICF - Unit 2
Organization subpart
Yes

Provider details

NPI number
Legal business name
COMMONWEALTH OF KENTUCKY
Authorized official
JENNIFER MOORE (ASSISTANT DIRECTOR)
(502) 782-6117
Entity
Organization

Contact information

Practice address
400 EASTWOOD DR, 2441 S. HWY 27, SOMERSET, KY 42501
(606) 667-4068
(606) 677-4068
Mailing address
400 EASTWOOD DR, 2441 S. HWY 27, SOMERSET, KY 42501
(606) 677-4068
(606) 677-4079

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
100426
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11900016
KY
Enumeration date
03/03/2009
Last updated
08/07/2024
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