Barnabas Home Inc

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

BARNABAS HOME INC

Practice address

95 Campus Drive
Annville, KY 40402

Phone

(606) 364-3640

Fax

(606) 364-2534

NPI assigned

Aug 22, 2019

Last updated

Aug 22, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eliza Diane Clontz, LPCC LCADC CSS

Title

Clinical Treatment Director

Phone

(606) 364-3640

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1689221764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 209",
            "city": "ANNVILLE",
            "state": "KY",
            "postal_code": "404020209",
            "telephone_number": "606-364-3640",
            "fax_number": "606-364-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 CAMPUS DRIVE",
            "city": "ANNVILLE",
            "state": "KY",
            "postal_code": "40402",
            "telephone_number": "606-364-3640",
            "fax_number": "606-364-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARNABAS HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "CLONTZ",
        "authorized_official_first_name": "ELIZA",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "CLINICAL TREATMENT DIRECTOR",
        "authorized_official_telephone_number": "606-364-3640",
        "authorized_official_credential": "LPCC LCADC CSS"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100283130",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Annville, KY
• Providers in Annville, KY by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.