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Organization

KENNEDY INDIVIDUALIZED COMMUNITY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GEORGE KENNEDY (EXECUTIVE DIRECTOR)
(270) 674-5654
Entity
Organization

Contact information

Practice address
6337 SHAW RD, MELBER, KY 42069-8834
(270) 674-5654
Mailing address
6337 SHAW RD, MELBER, KY 42069-8834
(270) 674-5654

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Enumeration date
04/17/2017
Last updated
04/17/2017
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