Organization
WESTERN KY REGIONAL MHMR BOARD INC
Active
Other names
Four Rivers Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRETCHEN E. ROOF (PRESIDENT/CEO)
(270) 442-7121
Entity
Organization
Contact information
Practice address
425 BROADWAY, SUITE 201, PADUCAH, KY 42001
(270) 442-7121
(270) 443-9692
Mailing address
425 BROADWAY ST STE 201, PADUCAH, KY 42001-0713
(270) 442-7121
(270) 443-9692
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
800001
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000057108
ANTHEM BCBS
KY
01
—
000000057108
ANTHEM BCBS
—
05
—
27001015
—
KY
05
—
28001014
—
KY
05
—
29100946
—
KY
05
—
29100948
—
KY
05
—
30601017
—
KY
05
—
33900242
—
KY
Enumeration date
07/14/2006
Last updated
02/11/2026
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