Shady Lawn I LLC

NPI #1922811181 in Cynthiana, Kentucky

Provider Information

NPI Number: 1922811181
Entity Type: Organization
Organization Name: Shady Lawn I LLC
Primary Specialty: Assisted Living Facility - Assisted Living, Mental Illness
Enumeration Date: Jan 30, 2025
Last Updated: Jan 30, 2025

Practice Location

Address: 108 S MILLER ST
City: Cynthiana
State: Kentucky
ZIP Code: 41031-1601
Phone: (516) 708-3503

Authorized Official

Name: RAQUEL EDERY
Title: COO
Phone: (516) 708-3503

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility - Assisted Living, Mental Illness — Assisted Living, Mental Illness	3104A0625X	Primary

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