Organization
FOUR CORNERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN WELCH (MANAGER)
(859) 443-4441
Entity
Organization
Contact information
Practice address
521 BARBERRY LN, NICHOLASVILLE, KY 40356-1701
(859) 443-4441
Mailing address
521 BARBERRY LN, NICHOLASVILLE, KY 40356-1701
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
05/03/2014
Last updated
05/03/2014
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