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General NPI Number Information
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NPI Number | 1164880258
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Entity Type | Organization
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Legal Business Name | COMPETITIVE EDGE II, LLC
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 3716 WILLOW RIDGE RD
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City | LEXINGTON
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State | KY
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Zip | 40514-1562
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Country | US
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Telephone | 859-296-9525
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Fax | 859-296-0625
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Provider Business Mailing Address
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Address Line | 3716 WILLOW RIDGE RD
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City | LEXINGTON
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State | KY
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Zip | 40514-1562
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Country | US
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Telephone | 859-296-9525
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Fax | 859-296-0625
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. JACKIE A HOWARD
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Credential |
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Telephone | 859-296-9525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 500164
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License Number State | KY
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