| Easterseals Redwood | |
|
71 Orphanage Rd Fort Mitchell KY 41017-3099 | |
| (859) 331-0880 | |
| (855) 704-1573 |
| Full Name | Easterseals Redwood |
|---|---|
| Speciality | Behavior Analyst |
| Location | 71 Orphanage Rd, Fort Mitchell, Kentucky |
| Authorized Official Name and Position | Pam Green (CEO) |
| Authorized Official Contact | 8593310880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easterseals Redwood 71 Orphanage Rd Fort Mitchell KY 41017-3099 Ph: (859) 331-0880 | Easterseals Redwood 71 Orphanage Rd Fort Mitchell KY 41017-3099 Ph: (859) 331-0880 |
| NPI Number | 1598364333 |
|---|---|
| Provider Enumeration Date | 10/22/2020 |
| Last Update Date | 11/17/2022 |
| Certification Date | 11/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598364333 | NPI | - | NPPES |
| 7100713640 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
Bolte Psychological Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Artillery Park Dr, Suite 102, Fort Mitchell, KY 41017 Phone: 859-426-0200 Fax: 859-426-0042 |