NPI 1043298979
Commonwealth of Kentucky
Practice location
- Address
- 5512 del Maria Way, Louisville, KY 40291-1810
- Phone
- (502) 361-2301
- Fax
- (502) 363-6114
- Mailing address
- 5512 Delmaria Way, Louisville, KY 40291-1810
Authorised official
- Name
- Jennifer Moore
- Title
- Assistant Director
- Phone
- (502) 782-6117
Registered specialties
Intellectual Disabilities Intermediate Care Facility
Primary
Registry record
- NPI
- 1043298979
- 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.