Provider Demographics
NPI:1518093319
Name:PUSH EARLY CHILDHOOD DEVELOPMENT CENTER
Entity Type:Organization
Organization Name:PUSH EARLY CHILDHOOD DEVELOPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-875-8666
Mailing Address - Street 1:959 LEESTOWN LN
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-2005
Mailing Address - Country:US
Mailing Address - Phone:502-875-8666
Mailing Address - Fax:
Practice Address - Street 1:959 LEESTOWN LN
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-2005
Practice Address - Country:US
Practice Address - Phone:502-875-8666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY354544251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)