Provider Demographics
NPI:1568218303
Name:KENTUCKY COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:KENTUCKY COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:859-324-2188
Mailing Address - Street 1:58 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:HUSTONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40437-9429
Mailing Address - Country:US
Mailing Address - Phone:859-324-2188
Mailing Address - Fax:
Practice Address - Street 1:58 SUNSET DR
Practice Address - Street 2:
Practice Address - City:HUSTONVILLE
Practice Address - State:KY
Practice Address - Zip Code:40437-9429
Practice Address - Country:US
Practice Address - Phone:859-324-2188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities