Organization
SUPPORT SOURCE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERYL BRUNER (EXECUTIVE DIRECTOR)
(859) 948-9404
Entity
Organization
Contact information
Practice address
233 STABLE WAY, NICHOLASVILLE, KY 40356-8046
(859) 948-9404
Mailing address
233 STABLE WAY, NICHOLASVILLE, KY 40356
(859) 948-9404
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/20/2007
Last updated
08/22/2020
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