Organization
WOMACK-CARTER OPTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BONNIE ANN MCCLURE MSW (CEO)
(270) 703-2966
Entity
Organization
Contact information
Practice address
3380 STATE ROUTE 121 N, MURRAY, KY 42071-7945
(270) 767-1543
(270) 767-1545
Mailing address
1305 FARRIS AVE, MURRAY, KY 42071-1803
(270) 767-1543
(270) 767-1545
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33000696
SCL MEDICAID WAIVER
KY
Enumeration date
05/03/2007
Last updated
03/27/2017
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