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1100 Walnut St Owensboro KY 42301-2956 | |
| (270) 689-6500 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1100 Walnut St, Owensboro, Kentucky |
| Authorized Official Name and Position | Michael Robert Huth (CFO) |
| Authorized Official Contact | 2706896500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1637 Owensboro KY 42302-1637 Ph: (270) 689-6500 | 1100 Walnut St Owensboro KY 42301-2956 Ph: (270) 689-6500 |
| NPI Number | 1154487304 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 09/01/2021 |
| Certification Date | 09/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154487304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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