Organization
KENTUCKY EASTER SEAL SOCIETY INC
Active
Parent organization
KENTUCKY EASTER SEAL SOCIETY INC
Other names
Cardinal Hill of Northern Kentucky
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENTUCKY EASTER SEAL SOCIETY INC
Authorized official
TIM M WILSON (VICE PRESIDENT CFO)
(859) 254-5701
Entity
Organization
Contact information
Practice address
31 SPIRAL DR, FLORENCE, KY 41042
(859) 525-1128
(859) 525-0351
Mailing address
PO BOX 4727, LEXINGTON, KY 40544-4727
(859) 254-5701
(859) 233-1615
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
100940
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000336625
ANTHEM PT
—
01
—
000000336653
ANTHEM OT
—
01
—
000000336691
ANTHEM ST
—
01
—
7717311
AETNA
—
01
—
94
FIRST STEPS
—
Enumeration date
10/25/2006
Last updated
04/20/2008
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