Healthcare Provider Details

I. General information

NPI: 1326192345
Provider Name (Legal Business Name): OPTIONS FOR INDIVIDUALS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 ENVOY CIR SUITE 2201
LOUISVILLE KY
40299-1827
US

IV. Provider business mailing address

2200 ENVOY CIR SUITE 2201
LOUISVILLE KY
40299-1827
US

V. Phone/Fax

Practice location:
  • Phone: 502-493-0007
  • Fax: 502-493-0021
Mailing address:
  • Phone: 502-493-0007
  • Fax: 502-493-0021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number33900143
License Number StateKY

VIII. Authorized Official

Name: MS. SONIA MARIE JOHNSON
Title or Position: EXECUTIVE DIRECTOR
Credential: CGW,MBA-HCM
Phone: 502-493-0007