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General NPI Number Information
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NPI Number | 1356056055
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Entity Type | Organization
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Legal Business Name | CENTER FOR ACCESSIBLE LIVING
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 501 S 2ND ST STE 200
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City | LOUISVILLE
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State | KY
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Zip | 40202-1864
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Country | US
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Telephone | 502-589-6620
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Fax | 502-589-3980
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Provider Business Mailing Address
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Address Line | 501 S 2ND ST STE 200
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City | LOUISVILLE
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State | KY
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Zip | 40202-1864
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Country | US
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Telephone | 502-589-6620
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Fax | 502-589-3980
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Authorized Official
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Title or Position | INTERIM EXECUTIVE DIRECTOR
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Name | AMANDA RAYE MOBLEY
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Credential | MBA
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Telephone | 502-589-6620
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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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