Organization
CUMBERLAND VALLEY DISTRICT HEALTH DEPARTMENT
Active
Other names
Cumberland Valley District Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLENNA HENSLEY (HOME HEALTH MANAGER)
(606) 598-5564
Entity
Organization
Contact information
Practice address
470 MANCHESTER SQUARE SHPG CTR, SUITE 200, MANCHESTER, KY 40962-8781
(606) 598-5564
(606) 598-6615
Mailing address
PO BOX 190, 470 MANCHESTER SQUARE SUITE 200, MANCHESTER, KY 40962-8781
(606) 598-5564
(606) 598-6615
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
150042
KY
251E00000X
Home Health Agency
Primary
150042
KY
251J00000X
Nursing Care Agency
150042
KY
252Y00000X
Early Intervention Provider Agency
150042
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34002261
—
KY
01
—
41055013
MODEL WAIVER
KY
01
—
42001263
KENTUCKY MEDICAID WAIVER
KY
01
—
45343696
EPSDT
KY
Enumeration date
12/05/2006
Last updated
09/07/2010
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