NPI 1033197967

Commonwealth of Kentucky

Organisation Intellectual Disabilities Intermediate Care Facility Louisville, KY

Practice location

Address: 1800 Bluegrass Ave, Louisville, KY 40215-1130
Phone: (502) 361-2301
Fax: (502) 363-6114

Authorised official

Name: Jennifer Moore
Title: Assistant Director
Phone: (502) 782-6117

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 100211 (KY)

Other Intermediate Care Facility, Intellectual Disabilities providers in Kentucky →

Registry record

NPI: 1033197967
Entity type: Organization
NPI issued: 30 Dec 2005
Record last updated: 7 Aug 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.