CREEKSIDE CHILD DEVELOPMENT SERVICES INC (NPI# 1861604142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861604142 |
| Entity Type | Organization |
| Organization Name | CREEKSIDE CHILD DEVELOPMENT SERVICES INC |
| Practice Address |
1120 Brush Creek Road Clay City KY 40312 |
| Practice Telephone | 6066633690 |
| Practice Fax Number | 6066633690 |
| Mailing Telephone | 6066633690 |
| Mailing Fax Number | 6066633690 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. IRENE LYNN HATTON (PRESIDENT OF AGENCY AND SOLE PROPRI) |
| Authorized Official Telephone | 6066633690 |
| Authorized Official Credential | DI DEVELOPMENTAL |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
KY | Ambulatory Health Care Facilities |
| Street Address |
1120 BRUSH CREEK ROAD |
| City | CLAY CITY |
| State | KY |
| Zip Code | 40312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104481993 | Tonya L Hogge | Home Health | 3660 Black Creek Rd, Clay City, KY 40312 | 2019-05-07 |
| 1932526654 | Lab One of Ohio Inc | Clinical Medical Laboratory | 98 Post Office Drive, Clay City, KY 40312 | 2014-03-19 |
| 1851545602 | Dorrita Mullins | Nurse Practitioner | 98 River Street, Clay City, KY 40312 | 2008-11-06 |
| 1609081124 | Gary J. Richardson | Pharmacist | 4644 Highway 15 W, Clay City, KY 40312 | 2007-05-10 |
| 1487793113 | Sandra Crum-stevens | Dentist | 98 River Street Suite A, Clay City, KY 40312 | 2007-02-06 |
| 1528110657 | Powell Adult Day Care | Clinic/Center | 176 12th Street, Clay City, KY 40312 | 2007-01-17 |
| 1295762987 | Jordan Drug, Inc. | Durable Medical Equipment & Medical Supplies | 4644 Highway 15 West, Clay City, KY 40312 | 2006-06-27 |
| 1265830996 | Sasha Flinchum | Pharmacist | 4644 Highway 15 West, Clay City, KY 40312 | 2014-12-11 |
| 1487869731 | Barry Livingston Rose | Pharmacist | 4644 Highway 15 West, Clay City, KY 40312 | 2007-05-11 |
| 1255545794 | Stephanie Elaine Ward | Registered Nurse | 68 Carmichael Dr., Clay City, KY 40312-0012 | 2007-05-10 |
| Find all providers in zip 40312 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366091738 | Green River Area Down Syndrome | Clinic/Center | 7155 Masonville Habit Rd, Philpot, KY 42366-9116 | 2019-09-09 |
| 1316086853 | Acsr, Inc. | Clinic/Center | 1165 Lakeway Dr, Russell Springs, KY 42642-4564 | 2007-02-05 |
| 1578602819 | Active Day Ky, Inc. | Clinic/Center | 1238 Woodland Dr, Elizabethtown, KY 42701-2767 | 2007-02-05 |
| 1497894935 | Acsr, Inc. | Clinic/Center | 928 Commercial Dr, Suite 2, Richmond, KY 40475-3403 | 2007-02-05 |
| 1053459701 | Acsr, Inc. | Clinic/Center | 100 St. Luke Pl, Suite B, Georgetown, KY 40324 | 2007-02-02 |
| 1487792453 | Acsr, Inc. | Clinic/Center | 6938 Us Route 60, Ashland, KY 41102-9519 | 2007-02-02 |
| 1235277971 | Active Day Ky, Inc. | Clinic/Center | 1035 Frederica St, Suite 170, Owensboro, KY 42301-3074 | 2007-02-02 |
| 1427196286 | Acsr, Inc. | Clinic/Center | 10 Hudson Hollow Rd, Frankfort, KY 40601-4311 | 2007-02-02 |
| 1477691301 | Active Day Ky, Inc. | Clinic/Center | 1297 Springfield Rd, Bardstown, KY 40004-2219 | 2007-02-02 |
| 1740328566 | Acsr, Inc. | Clinic/Center | 1860 Old Lebanon Rd, Campbellsville, KY 42718-9663 | 2007-02-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.