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General NPI Number Information
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NPI Number | 1851450464
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Entity Type | Organization
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Legal Business Name | CEREBRAL PALSY KIDS CENTER INC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 982 EASTERN PARKWAY
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City | LOUISVILLE
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State | KY
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Zip | 40217-1501
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Country | US
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Telephone | 502-635-6397
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Fax | 502-635-1147
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Provider Business Mailing Address
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Address Line | 982 EASTERN PARKWAY # 6
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City | LOUISVILLE
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State | KY
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Zip | 40217-1501
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Country | US
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Telephone | 502-635-6397
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Fax | 502-635-1147
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BRITTANY LUTKE
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Credential |
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Telephone | 502-635-6397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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