PENTECOSTAL CHILDREN'S HOME (NPI# 1811430978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811430978 |
| Entity Type | Organization |
| Organization Name | PENTECOSTAL CHILDREN'S HOME |
| Other Organization Name | APPALACHIAN CHILDREN'S HOME |
| Practice Address |
1909 Ky 3439 Barbourville KY 40906-7201 |
| Mailing Address |
Po Box 550 Barbourville KY 40906-0550 |
| Practice Telephone | 6065463805 |
| Practice Fax Number | 6065463903 |
| Mailing Telephone | 6065463805 |
| Mailing Fax Number | 6065463903 |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2019-06-04 |
| Authorized Official Name | MISS HOLLY R TAYLOR (TREATMENT DIRECTOR) |
| Authorized Official Telephone | 6065463805 |
| Authorized Official Credential | LPCC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 253J00000X | Foster Care Agency | Agencies | ||
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
810530 | KY | Residential Treatment Facilities |
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 800232 | KY | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Appalachian Children's Home | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Pentecostal Children's Home Inc. | 1909 Ky 3439, Po Box 550, Barbourville, Kentucky 40906 |
| Street Address |
1909 KY 3439 |
| City | BARBOURVILLE |
| State | KY |
| Zip Code | 40906-7201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679791610 | Holly Ray Taylor-williams | Counselor | 1909 Ky 3439, Barbourville, KY 40906-7201 | 2007-04-23 |
| 1417518010 | Rebecca Brooke Hurley | Counselor | 1909 Ky 3439, Barbourville, KY 40906-7201 | 2019-06-25 |
| 1972164689 | Amanda Elizabeth Ellis | Counselor | 1909 Ky 3439, Barbourville, KY 40906-7201 | 2019-06-24 |
| 1194225748 | Thomas R Tribell Jr. | Counselor | 1909 Ky 3439, Barbourville, KY 40906-7201 | 2018-02-20 |
| 1366940744 | Grace Community Health Center Inc | Clinic/Center | 1909 Ky 3439, Barbourville, KY 40906-7201 | 2018-01-31 |
| 1982113759 | Jamie Hobbs | Counselor | 1909 Ky 3439, Barbourville, KY 40906-7201 | 2017-09-25 |
| 1033628037 | Brandy Marie Williamson | Counselor | 1909 Ky 3439, Barbourville, KY 40906-7201 | 2017-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477187334 | Barbourville Prescription Center, LLC | Pharmacy | 1881 South U.S. Highway 25e, Barbourville, KY 40906 | 2020-02-28 |
| 1992368617 | Carolyn Disney Byble | Counselor | 1909 Hwy. 3439, Barbourville, KY 40906 | 2019-04-18 |
| 1386139111 | Amy Lynn Mills | Adult Companion | 12 Knox Plaza, Barbourville, KY 40906 | 2018-06-25 |
| 1457858250 | Angela Turner | Nurse Practitioner | 1927 Us S Hwy 25e, Barbourville, KY 40906 | 2018-04-09 |
| 1376049437 | Kalee Elizabeth Howard | Case Manager/Care Coordinator | 415 Highway 225, Barbourville, KY 40906 | 2018-04-05 |
| 1063949303 | Robin Renee Carr | Counselor | 415 Ky Hwy 225, Barbourville, KY 40906 | 2017-05-17 |
| 1770940736 | Jennifer Nicole James | Case Manager/Care Coordinator | 415 Ky 225, Barbourville, KY 40906 | 2016-01-21 |
| 1891116455 | Glenna Bargo | Nurse Practitioner | 728 S Us Highway 25e Loop Number 2, Loop Number 2, Barbourville, KY 40906 | 2013-12-30 |
| 1275883050 | Brian Keith Abner | Physician Assistant | 215 North Allison Avenue, Barbourville, KY 40906 | 2012-09-19 |
| 1558660944 | Sleep Diagnostics of Kentucky, Inc | Clinic/Center | 606a Knox Street, Barbourville, KY 40906 | 2011-03-24 |
| Find all providers in zip 40906 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295108553 | St Joseph Peace Mission for Children | Residential Treatment Facility, Emotionally Disturbed Children | 1328 W 3rd St, Owensboro, KY 42301-1901 | 2015-11-09 |
| 1346652476 | New Pathways for Children, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 3311 Shaw Rd, Melber, KY 42069-8738 | 2014-05-23 |
| 1770927535 | Sunrise Children's Services | Residential Treatment Facility, Emotionally Disturbed Children | 2495 Cranston Rd, Morehead, KY 40351 | 2013-04-24 |
| 1780027656 | Sunrise Children's Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 854 Tunnel Hill Church Road, Elizabethtown, KY 42701 | 2013-04-10 |
| 1285974352 | Sunrise Children's Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 330 Hope Street, Mt. Washington, KY 40047 | 2013-02-26 |
| 1487936449 | Florence Crittenton Home | Residential Treatment Facility, Emotionally Disturbed Children | 519 W Fourth St, Lexington, KY 40508-1205 | 2011-09-15 |
| 1851435705 | Bellewood Presbyterian Home for Children | Residential Treatment Facility, Emotionally Disturbed Children | 11103 Park Rd, Louisville, KY 40223-2424 | 2007-02-16 |
| 1912089863 | Home of The Innocents | Residential Treatment Facility, Emotionally Disturbed Children | 1100 E. Market St., Louisville, KY 40206 | 2006-10-19 |
| 1699710798 | Campbell Lodge Boys' Home | Residential Treatment Facility, Emotionally Disturbed Children | 5161 Skyline Dr, Highland Heights, KY 41076-3545 | 2006-06-20 |
| 1821432394 | Sunrise Children's Services | Residential Treatment Facility, Emotionally Disturbed Children | 1030 Commerce Dr, Elizabethtown, KY 42701 | 2013-04-26 |
| Find all providers with the same taxonomy | ||||
| City | BARBOURVILLE |
| Zip Code | 40906 |
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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.