MDH Management Group, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

33000621 Issued in KY

Legal business name

MDH MANAGEMENT GROUP, INC.

Practice address

12706 Crestmoor Cir
Prospect, KY 40059-9181

Phone

(502) 292-0734

NPI assigned

Jan 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Drew Haynes

Title

Chief Executive Officer

Phone

(502) 292-0734

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568519510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12706 CRESTMOOR CIR",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400599181",
            "telephone_number": "502-292-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12706 CRESTMOOR CIR",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400599181",
            "telephone_number": "502-292-0734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDH MANAGEMENT GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "DREW",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "502-292-0734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "KY",
            "license": "33000621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3300062100",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert K. McDonald, O.D.
• Rebekah McIlvoy, MS, OTR/L
• Terence P McKenna, MD
• Rachel Brooks McKinley Jeffries, DPT
• Shelby Rene McWilliams, OTR/L
• Med-Life-Fit Medical and Lifestyle Management Family Medical Center L (Kentuckiana Medical Weight Loss Centers)
• Jennifer Metts
• Donna A. Meyer, P.T.
• Mian Consulting, Inc
• Milburn Services, Inc (Step One Therapy)

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Prospect, KY
• Providers in Prospect, KY by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.