Provider Demographics
NPI:1073761839
Name:HEALTH SERVICES PERSONNEL
Entity type:Organization
Organization Name:HEALTH SERVICES PERSONNEL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRIVACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:OMBRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-394-2387
Mailing Address - Street 1:9901 LINN STATION RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3808
Mailing Address - Country:US
Mailing Address - Phone:800-866-0860
Mailing Address - Fax:
Practice Address - Street 1:233 E MODLIN RD
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-8220
Practice Address - Country:US
Practice Address - Phone:800-866-0860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251B00000X, 251C00000X, 251E00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300520HMedicaid
NC8300522HMedicaid
NC8300526HMedicaid
NC8300526BMedicaid
NC8300528GMedicaid
NC8300498Medicaid
NC8300646GMedicaid
NC8300787HMedicaid
NC8300498BMedicaid
NC8300498GMedicaid
NC8300528HMedicaid
NC8300646HMedicaid
NC8300498HMedicaid
NC8300500BMedicaid
NC8300523HMedicaid
NC8300526GMedicaid
NC8300500HMedicaid
NC8300534HMedicaid