Provider Demographics
NPI:1477424752
Name:ISAIAH HOUSE INC
Entity type:Organization
Organization Name:ISAIAH HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-755-7433
Mailing Address - Street 1:4185 LEXINGTON RD
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1736
Mailing Address - Country:US
Mailing Address - Phone:859-275-9200
Mailing Address - Fax:
Practice Address - Street 1:4185 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1736
Practice Address - Country:US
Practice Address - Phone:859-275-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty