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General NPI Number Information
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NPI Number | 1023642444
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Entity Type | Organization
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Legal Business Name | KENDRICK BRAIN RESTORATION
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 15255 S 94TH AVE STE 500
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City | ORLAND PARK
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State | IL
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Zip | 60462-3895
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Country | US
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Telephone | 502-345-1487
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Fax |
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Provider Business Mailing Address
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Address Line | 5501 RUSTIC WAY
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City | LOUISVILLE
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State | KY
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Zip | 40218-4251
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Country | US
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Telephone | 502-345-1487
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. UNEKA SHERVON KENDRICK
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Credential |
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Telephone | 502-345-1487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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