NPI 1104510502

Personal Care Agency

Organisation Assisted Living Facility (Mental Illness) Louisville, KY

Practice location

Address: 2305 Grand Ave, Louisville, KY 40210-1145
Phone: (502) 777-9201

Authorised official

Name: Shavonda Hill
Title: Owner
Phone: (502) 416-2988

Registered specialties (2)

Assisted Living Facility (Mental Illness) Primary

Nursing & Custodial Care Facilities Taxonomy 3104A0625X

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Non-emergency Medical Transport (VAN)

Transportation Services Taxonomy 343900000X

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Registry record

NPI: 1104510502
Entity type: Organization
NPI issued: 7 Jun 2023
Record last updated: 7 Jun 2023

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.