Healthcare Provider Details

I. General information

NPI: 1982758728
Provider Name (Legal Business Name): KORT - CARITAS REHAB SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4402 CHURCHMAN AVE SUITE 103
LOUISVILLE KY
40215-1190
US

IV. Provider business mailing address

4402 CHURCHMAN AVE SUITE 103
LOUISVILLE KY
40215-1190
US

V. Phone/Fax

Practice location:
  • Phone: 502-361-5253
  • Fax: 502-361-9038
Mailing address:
  • Phone: 502-361-5253
  • Fax: 502-361-9038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberR1730
License Number StateKY

VIII. Authorized Official

Name: AURIA NUNEZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 502-361-5253