Healthcare Provider Details

I. General information

NPI: 1043086127
Provider Name (Legal Business Name): LATINO CASE MANAGEMENT, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 MOUNT EDEN RD
SHELBYVILLE KY
40065-8820
US

IV. Provider business mailing address

5511 FERN BROOK LN
LOUISVILLE KY
40291-1928
US

V. Phone/Fax

Practice location:
  • Phone: 502-437-0053
  • Fax:
Mailing address:
  • Phone: 502-216-0553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLARENA WRIGHT
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 502-216-0553