Healthcare Provider Details

I. General information

NPI: 1841498698
Provider Name (Legal Business Name): DOWN SYNDROME OF LOUISVILLE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 09/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 S HURSTBOURNE PKWY
LOUISVILLE KY
40291-2893
US

IV. Provider business mailing address

5001 S HURSTBOURNE PKWY
LOUISVILLE KY
40291-2893
US

V. Phone/Fax

Practice location:
  • Phone: 502-495-5088
  • Fax: 502-495-5038
Mailing address:
  • Phone: 502-495-5088
  • Fax: 502-495-5038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberKY-1424
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER L. KIMES
Title or Position: EXEC. DIRECTOR OF CLINICAL SERVICES
Credential: PSY.D.
Phone: 502-495-5088