Provider Demographics
NPI:1841349560
Name:PIONEER VOCATIONAL INDUSTRIAL SERVICES,INC.
Entity type:Organization
Organization Name:PIONEER VOCATIONAL INDUSTRIAL SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF SCL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:EAST
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:859-236-8413
Mailing Address - Street 1:PO BOX 1396
Mailing Address - Street 2:150 CORPORATE DR.
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40423-1396
Mailing Address - Country:US
Mailing Address - Phone:859-236-8413
Mailing Address - Fax:859-238-7115
Practice Address - Street 1:150 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40423-1396
Practice Address - Country:US
Practice Address - Phone:859-236-8413
Practice Address - Fax:859-238-7115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY33000217Medicaid