Provider Demographics
NPI:1619357498
Name:SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF KENTUCKY-BOWLING GR
Entity Type:Organization
Organization Name:SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF KENTUCKY-BOWLING GR
Other - Org Name:SAFY OF KENTUCKY - BOWLING GREEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STATE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:502-475-5547
Mailing Address - Street 1:10100 ELIDA RD
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-9058
Mailing Address - Country:US
Mailing Address - Phone:419-695-8010
Mailing Address - Fax:606-328-5153
Practice Address - Street 1:901 LEHMAN AVE STE 7
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-4903
Practice Address - Country:US
Practice Address - Phone:270-904-6307
Practice Address - Fax:606-328-5153
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPECIALIZED ALTERNATIVES FOR FAMILIES AND YOUTH OF KENTUCKY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-05
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health