Provider Demographics
NPI:1508562380
Name:CHILDREN'S HOME OF NORTHERN KENTUCKY
Entity Type:Organization
Organization Name:CHILDREN'S HOME OF NORTHERN KENTUCKY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF STRATEGY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-292-4162
Mailing Address - Street 1:200 HOME RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-5634
Mailing Address - Country:US
Mailing Address - Phone:859-261-8768
Mailing Address - Fax:859-291-2431
Practice Address - Street 1:4836 IDLEWILD RD # B2
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KY
Practice Address - Zip Code:41005-8742
Practice Address - Country:US
Practice Address - Phone:859-261-8768
Practice Address - Fax:859-291-2431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility