Provider Demographics
NPI:1346874054
Name:KENTUCKY RIVER FOOTHILLS DEVELOPMENT COUNCIL, INC.
Entity Type:Organization
Organization Name:KENTUCKY RIVER FOOTHILLS DEVELOPMENT COUNCIL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:A
Authorized Official - Last Name:WOOLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-663-9011
Mailing Address - Street 1:309 SPANGLER DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2457
Mailing Address - Country:US
Mailing Address - Phone:859-624-2046
Mailing Address - Fax:
Practice Address - Street 1:100 TYLER LN
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:KY
Practice Address - Zip Code:40336-8827
Practice Address - Country:US
Practice Address - Phone:606-531-2012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENTUCKY RIVER FOOTHILLS DEVELOPMENT COUNCIL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)