Organization
FOOTPRINTS OUTREACH AND SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL RAY CANTRELL APSS, CPRS, TRADPSS (EXECUTIVE DIRECTOR)
(270) 846-6335
Entity
Organization
Contact information
Practice address
618 MCELWAIN CT, BOWLING GREEN, KY 42101-3524
(270) 846-6335
Mailing address
508 CLEARVIEW ST, FRANKLIN, KY 42134-2037
(270) 846-6335
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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