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General NPI Number Information
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NPI Number | 1437346145
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Entity Type | Organization
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Legal Business Name | COMMUNITY FAMILY LIVING, LLC
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 06/27/2011
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Provider Practice Location Address
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Address Line | 610 VALLEY COLLEGE DR.
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City | LOUISVILLE
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State | KY
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Zip | 40272
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Country | US
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Telephone | 502-363-2500
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Fax | 502-367-0725
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Provider Business Mailing Address
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Address Line | 4305 JASPER CT.
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City | LOUISVILLE
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State | KY
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Zip | 40272-7210
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Country | US
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Telephone | 502-363-2500
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Fax | 502-367-0725
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. LARRY E. THOMPSON
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Credential | CEO
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Telephone | 502-363-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 33000936
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License Number State | KY
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