Healthcare Provider Details

I. General information

NPI: 1720994247
Provider Name (Legal Business Name): WELCOME WAIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2337 FAUSZ RD
MELBOURNE KY
41059-9433
US

IV. Provider business mailing address

2337 FAUSZ RD
MELBOURNE KY
41059-9433
US

V. Phone/Fax

Practice location:
  • Phone: 859-391-6117
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: TERRI ANGEL
Title or Position: OWNER/EXECUTIVE DIRECTOR
Credential:
Phone: 859-391-6117