Provider Demographics
NPI:1326463910
Name:THE BAIR FOUNDATION
Entity Type:Organization
Organization Name:THE BAIR FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MIKLOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-946-8711
Mailing Address - Street 1:241 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEW WILMINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16142-1116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2393 ALUMNI DR
Practice Address - Street 2:SUITE 205
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-4285
Practice Address - Country:US
Practice Address - Phone:859-519-3273
Practice Address - Fax:859-519-3274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY500632253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY253J00000XMedicaid