Provider Demographics
NPI:1821218694
Name:WESTCARE KENTUCKY, INC.
Entity Type:Organization
Organization Name:WESTCARE KENTUCKY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF SERVICES AND PROGRAM OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:NERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-490-6767
Mailing Address - Street 1:PO BOX 12019
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33733-2019
Mailing Address - Country:US
Mailing Address - Phone:727-490-6767
Mailing Address - Fax:727-823-0573
Practice Address - Street 1:10057 ELKHORN CRK
Practice Address - Street 2:
Practice Address - City:ASHCAMP
Practice Address - State:KY
Practice Address - Zip Code:41512-8702
Practice Address - Country:US
Practice Address - Phone:606-754-7077
Practice Address - Fax:606-754-7079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY800185251S00000X
KY810201324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral Health