Provider Demographics
NPI:1770815979
Name:VINEYARD CHRISTIAN FELLOWSHIP OF NORTHERN KENTUCKY
Entity Type:Organization
Organization Name:VINEYARD CHRISTIAN FELLOWSHIP OF NORTHERN KENTUCKY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-689-0777
Mailing Address - Street 1:7101 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-9529
Mailing Address - Country:US
Mailing Address - Phone:859-689-0777
Mailing Address - Fax:859-689-0777
Practice Address - Street 1:7101 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-9529
Practice Address - Country:US
Practice Address - Phone:859-689-0777
Practice Address - Fax:859-689-0777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty