Provider Demographics
NPI:1407589823
Name:AT HOME CARE OF KENTUCKY, INC
Entity Type:Organization
Organization Name:AT HOME CARE OF KENTUCKY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-232-8769
Mailing Address - Street 1:1719 ASHLEY CIR STE 110
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-5837
Mailing Address - Country:US
Mailing Address - Phone:270-904-0115
Mailing Address - Fax:270-904-0071
Practice Address - Street 1:1719 ASHLEY CIR STE 110
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-5837
Practice Address - Country:US
Practice Address - Phone:270-904-0115
Practice Address - Fax:270-904-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-04
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care