Organization
COMMONWEALTH OF KENTUCKY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GAYLENE MORROW (BILLING CLERK)
(606) 788-6600
Entity
Organization
Contact information
Practice address
5659 MAIN ST, THELMA, KY 41260-8609
(606) 788-6600
(606) 788-7076
Mailing address
5659 MAIN ST, THELMA, KY 41260-8609
(606) 788-6600
(606) 788-7076
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/25/2007
Last updated
06/30/2010
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