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General NPI Number Information
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NPI Number | 1275182255
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Entity Type | Organization
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Legal Business Name | THE KIDZ CLUB-PDN, LLC
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Dates
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Enumeration Date | 09/11/2019
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1537 HIGHWAY 185 SUITE 3
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City | BOWLING GREEN
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State | KY
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Zip | 42101
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Country | US
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Telephone | 502-210-5538
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Fax | 502-327-5098
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Provider Business Mailing Address
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Address Line | 1101 HERR LN
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City | LOUISVILLE
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State | KY
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Zip | 40222-4301
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Country | US
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Telephone | 502-210-5538
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Fax | 502-327-5098
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Authorized Official
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Title or Position | PRESIDENT
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Name | JODY ROGERS
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Credential |
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Telephone | 502-210-5538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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