Personal Care Agency

NPI #1104510502 in Louisville, Kentucky

Provider Information

NPI Number: 1104510502
Entity Type: Organization
Organization Name: Personal Care Agency
Primary Specialty: Assisted Living Facility - Assisted Living, Mental Illness
Enumeration Date: Jun 7, 2023
Last Updated: Jun 7, 2023

Practice Location

Address: 2305 GRAND AVE
City: Louisville
State: Kentucky
ZIP Code: 40210-1145
Phone: (502) 777-9201

Authorized Official

Name: MS. SHAVONDA HILL
Title: OWNER
Phone: (502) 416-2988

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Non-emergency Medical Transport (VAN)	343900000X
Assisted Living Facility - Assisted Living, Mental Illness — Assisted Living, Mental Illness	3104A0625X	Primary

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