Provider Demographics
NPI:1356528699
Name:CHILDREN'S HEALTH FIRST
Entity type:Organization
Organization Name:CHILDREN'S HEALTH FIRST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:V
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-459-2397
Mailing Address - Street 1:2826 HOOCK AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2914
Mailing Address - Country:US
Mailing Address - Phone:502-459-2397
Mailing Address - Fax:
Practice Address - Street 1:1444 WOODBRIDGE TRL
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-7546
Practice Address - Country:US
Practice Address - Phone:270-929-7888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric