Provider Demographics
NPI:1306379326
Name:ENABLING TECHNOLOGIES OF KENTUCKIANIA
Entity Type:Organization
Organization Name:ENABLING TECHNOLOGIES OF KENTUCKIANIA
Other - Org Name:ENTECH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTON
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKULLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:502-873-4218
Mailing Address - Street 1:845 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2213
Mailing Address - Country:US
Mailing Address - Phone:502-992-2448
Mailing Address - Fax:502-585-7104
Practice Address - Street 1:812 S 2ND ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2275
Practice Address - Country:US
Practice Address - Phone:502-992-2448
Practice Address - Fax:502-585-7104
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPALDING UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty