NPI 1790232577

Cedar Lake Lodge/Sycamore Run

Organisation Intellectual Disabilities Intermediate Care Facility Louisville, KY

Practice location

Address: 9505 Williamsburg Plz STE 200, Louisville, KY 40222-5082
Phone: (502) 495-4953
Fax: (502) 425-3540

Authorised official

Name: Courtney Elaine Grimes
Title: Reimbursement Specialist
Phone: (502) 495-4953

Registered specialties (2)

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 101247 (KY)

Other Intermediate Care Facility, Intellectual Disabilities providers in Kentucky →

Mental Illness Intermediate Care Facility

Nursing & Custodial Care Facilities Taxonomy 310500000X Licence 101246 (KY)

Other Intermediate Care Facility, Mental Illness providers in Kentucky →

Registry record

NPI: 1790232577
Entity type: Organization
NPI issued: 8 Sep 2016
Record last updated: 31 Jan 2022

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.