WENDELL FOSTER'S CAMPUS FOR DEVELOPMENTAL DISABILITIES
Intermediate Care Facility, Mentally Retarded
Owensboro, Kentucky
Provider NPI: 1407879349
Organization Information:Organization Name: WENDELL FOSTER'S CAMPUS FOR DEVELOPMENTAL DISABILITIES
Practice Location:
815 TRIPLETT ST OWENSBORO, KY 42303 US
Tel: 270-683-4517 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
815 TRIPLETT ST OWENSBORO, KY 42303 US
Tel: 270-683-4517 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapist | KY | |
N | 235Z00000X | Speech, Language and Hearing Service Providers Speech-Language Pathologist | KY | |
N | 261QM0850X | Ambulatory Health Care Facilities Clinic/Center | KY | |
N | 261QR0401X | Ambulatory Health Care Facilities Clinic/Center | KY | |
N | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | KY | |
Y | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist | KY |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
33000035 | KY | 05 | |
11903135 | KY | 05 | |
184517 | 184517 | KY | 01 |
7100337840 | KY | 05 | |
7100343070 | KY | 05 | |
7100344330 | KY | 05 | |
7100427110 | KY | 05 | |
45118379 | KY | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin