Commonwealth of Kentucky
NPI #1033197967 in Louisville, Kentucky
Provider Information
- NPI Number
- 1033197967
- Entity Type
- Organization
- Organization Name
- Commonwealth of Kentucky
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- COMMONWEALTH OF KENTUCKY
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Dec 30, 2005
- Last Updated
- Aug 7, 2024
Practice Location
- Address
- 1800 BLUEGRASS AVE
- City
- Louisville
- State
- Kentucky
- ZIP Code
- 40215-1130
- Phone
- (502) 361-2301
Authorized Official
- Name
- JENNIFER MOORE
- Title
- ASSISTANT DIRECTOR
- Phone
- (502) 782-6117
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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