Organization Name: | CENTRAL KENTUCKY SUPPORTIVE LIVING, INC |
NPI Number: | 1437317203 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CONNIE C CLARK (CONTROLLER) |
Mailing Address: | 650 Peeled Oak Rd Owingsville |
State: | KY US |
Postal Code: | 403608047 |
Phone Number: | 6066746962 |
Fax Number: | |
NPI Enumeration Date: | 05/29/2008 |
NPI Last Update Date: | 05/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |