Healthcare Provider Details

I. General information

NPI: 1417129628
Provider Name (Legal Business Name): NEWCARE OF LOUISVILLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8919 STONE GREEN WAY SUITE 200
LOUISVILLE KY
40220-4073
US

IV. Provider business mailing address

8919 STONE GREEN WAY SUITE 200
LOUISVILLE KY
40220-4073
US

V. Phone/Fax

Practice location:
  • Phone: 502-452-9089
  • Fax:
Mailing address:
  • Phone: 502-452-9089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: AMY NEWKIRK
Title or Position: EXECUTIVE DIRECTOR
Credential: MRC, CRC, CCM
Phone: 502-452-9089