Organization
HOMEPLACE SUPPORT SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE JACKSON (PROGRAM SUPERVISOR)
(859) 936-2010
Entity
Organization
Contact information
Practice address
215 S 4TH ST, DANVILLE, KY 40422-1827
(859) 936-2010
(859) 936-2099
Mailing address
215 S 4TH ST, DANVILLE, KY 40422-1827
(859) 936-2010
(859) 936-2099
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
251B00000X
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33001249
—
KY
Enumeration date
04/25/2007
Last updated
08/22/2020
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