Provider Demographics
NPI:1952466161
Name:KENTUCKIANA CENTER FOR EDUCATION, HEALTH AND RESEARCH, INC
Entity Type:Organization
Organization Name:KENTUCKIANA CENTER FOR EDUCATION, HEALTH AND RESEARCH, INC
Other - Org Name:KENTUCKIANA CHILDREN'S CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF CHIROPRACTIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-893-7227
Mailing Address - Street 1:1810 BROWNSBORO RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2112
Mailing Address - Country:US
Mailing Address - Phone:502-893-7227
Mailing Address - Fax:502-368-2308
Practice Address - Street 1:1810 BROWNSBORO RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-2112
Practice Address - Country:US
Practice Address - Phone:502-893-7227
Practice Address - Fax:502-368-2308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85043826Medicaid
KY8590038900Medicaid
KY8590038900Medicaid