Organization
EASTER SEALS WEST KENTUCKY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE HENRY (OPERATIONS MANAGER)
(270) 444-7898
Entity
Organization
Contact information
Practice address
619 N 30TH ST, PADUCAH, KY 42001-4047
(270) 444-9687
Mailing address
801 N 29TH ST, PADUCAH, KY 42001-4056
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
251300000X
Local Education Agency (LEA)
—
—
261QM3000X
Medically Fragile Infants and Children Day Care
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45229952
EPSDT
KY
05
—
45229952
—
KY
Enumeration date
02/20/2007
Last updated
12/17/2024
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