Organization
SPECTRE & QUEEN
Active
Other names
FirstLight of the Foothills
Organization subpart
No
Provider details
NPI number
Authorized official
SHADOW LEE SKAGGS (CO-OWNER)
(606) 393-0669
Entity
Organization
Contact information
Practice address
326 S COURT ST, GRAYSON, KY 41143-1269
(606) 393-0669
(606) 393-0675
Mailing address
326 S COURT ST, GRAYSON, KY 41143-1269
(606) 393-0669
(606) 393-0675
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
500280
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500280
COMMONWEALTH OF KENTUCKY CABINET FOR HEALTH AND FAMILY SERVICES
KY
Enumeration date
09/19/2017
Last updated
07/21/2022
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