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General NPI Number Information
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NPI Number | 1063579233
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Entity Type | Organization
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Legal Business Name | HIGHLANDS COMMUNITY MINISTRIES SENIOR SERVICES ADULT DAY HEALTH CENT
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2000 DOUGLASS BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40205-1928
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Country | US
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Telephone | 502-459-4887
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Fax | 502-452-1484
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Provider Business Mailing Address
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Address Line | 2000 DOUGLASS BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40205-1928
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Country | US
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Telephone | 502-459-4887
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Fax | 502-452-1484
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. MARY LYNNE MASTERSON
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Credential |
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Telephone | 502-459-4887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 750003
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License Number State | KY
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