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General NPI Number Information
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NPI Number | 1073102786
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Entity Type | Organization
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Legal Business Name | ZORA'S CRADLE, LLC
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Dates
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Enumeration Date | 01/16/2021
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Last Update Date | 01/16/2021
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Provider Practice Location Address
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Address Line | 6844 BARDSTOWN RD # 838
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City | LOUISVILLE
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State | KY
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Zip | 40291-3050
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Country | US
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Telephone | 502-830-9460
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Fax |
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Provider Business Mailing Address
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Address Line | 6844 BARDSTOWN RD # 838
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City | LOUISVILLE
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State | KY
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Zip | 40291-3050
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Country | US
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Telephone | 502-830-9460
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SHEMIKA WHITESIDE
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Credential | MSSW, CSW
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Telephone | 502-830-9460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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