=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457457798
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOUSECALLS OF AMERICA, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2006
-----------------------------------------------------
Last Update Date | 07/03/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4139 CADILLAC CT SUITE 100
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40213-1578
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-238-5150
-----------------------------------------------------
Fax | 502-238-5180
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9510 ORMSBY STATION RD SUITE 300
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40223-4081
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-891-1000
-----------------------------------------------------
Fax | 502-891-8067
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SR. V.P., ADMINISTRATION
-----------------------------------------------------
Name | MR. PATRICK TODD LYLES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 502-891-1044
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 150128
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------