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General NPI Number Information
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NPI Number | 1295880441
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Entity Type | Organization
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Legal Business Name | LINCOLN TRAIL AREA DEVELOPMENT DISTRICT
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/19/2024
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Provider Practice Location Address
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Address Line | 750 S PROVIDENT WAY
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-5956
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Country | US
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Telephone | 270-769-2393
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Fax | 270-769-2993
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Provider Business Mailing Address
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Address Line | 750 S PROVIDENT WAY
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-5956
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Country | US
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Telephone | 270-769-2393
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Fax | 270-769-2993
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DANIEL LONDON
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Credential |
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Telephone | 270-769-2393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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