Provider Demographics
NPI:1730587627
Name:OPPORTUNITY WORKSHOP OF LEXINGTON
Entity type:Organization
Organization Name:OPPORTUNITY WORKSHOP OF LEXINGTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ISAAC
Authorized Official - Last Name:BOGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-254-0576
Mailing Address - Street 1:650 KENNEDY RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-1819
Mailing Address - Country:US
Mailing Address - Phone:859-254-0576
Mailing Address - Fax:859-254-0578
Practice Address - Street 1:650 KENNEDY RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-1819
Practice Address - Country:US
Practice Address - Phone:859-254-0576
Practice Address - Fax:859-254-0578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable