Commonwealth of Kentucky
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Somerset, KY
NPI 1679713630 · NPPES record last updated Aug 7, 2024
Key facts
- NPI
- 1679713630
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- License
- 100426 (KY)
- Legal business name
- COMMONWEALTH OF KENTUCKY
- Practice address
- 400 Eastwood Dr
2441 S. Hwy 27
Somerset, KY 42501 - Phone
- (606) 667-4068
- Fax
- (606) 677-4068
- NPI assigned
- Mar 3, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- COMMONWEALTH OF KENTUCKY
Authorized official
- Name
- Jennifer Moore
- Title
- Assistant Director
- Phone
- (502) 782-6117
Corporate family (same tax ID) 24
Practitioners 2
-
Robin Cherron Duncan, APRN
-
Carla Michelle Wilson, RN, APRN-CNP
National Provider Directory
- Tax ID family
- West Liberty Elementary
- Part of
- West Liberty Elementary
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 100426 | KY | Yes |
Addresses
Primary practice location
400 Eastwood Dr
2441 S. Hwy 27
Somerset, KY 42501
Mailing address
400 Eastwood Dr
2441 S. Hwy 27
Somerset, KY 42501
Phone (606) 677-4068
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11900016 | Medicaid | KY |
Other names
- Oakwood ICF - Unit 2
Other providers in Somerset, KY
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All providers in Somerset, KY · Intellectual Disabilities Intermediate Care Facility in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.