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Kentucky River Community Care, Inc

Organization Active NPI Case Manager/Care Coordinator · Hazard, KY

NPI 1023299062 · NPPES record last updated Sep 19, 2023

Key facts

NPI
1023299062
Entity type
Organization (NPI type 2)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Legal business name
KENTUCKY RIVER COMMUNITY CARE, INC
Practice address
115 Rockwood LN
Hazard, KY 41701-9415
Phone
(606) 436-5761
Fax
(606) 436-5797
NPI assigned
Nov 19, 2007
Organization subpart
No

Authorized official

Name
Marcia Adams
Title
Cfo
Phone
(606) 666-4351

Corporate family (same tax ID) 5

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Ky River Comm Care (6 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator
Group: 193200000X MULTI-SPECIALTY GROUP		 171M00000X Yes

Addresses

Primary practice location

115 Rockwood LN
Hazard, KY 41701-9415

Mailing address

115 Rockwood LN
Hazard, KY 41701-9415
Phone (606) 436-5761

Other identifiers

IdentifierTypeStateIssuer
28012011MedicaidKY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 19, 2023.

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1023299062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "606-436-5761",
            "fax_number": "606-436-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "606-436-5761",
            "fax_number": "606-436-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY RIVER COMMUNITY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "606-666-4351"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28012011",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

All providers in Hazard, KY · Case Manager/Care Coordinator in Kentucky

Sources for this page

Verify at the official NPI Registry.